European Journal of Molecular & Clinical Medicine

Background: Ovarian cancer is the most frequent cause of death from gynaecological cancers and the fourth most frequent cause of death from cancer in women in Europe, United States and India. The present study was conducted to assess distribution of neoplastic and non- neoplastic ovarian lesions.
Materials & Methods: 74 patients age ranged 18- 48 years was recorded. The histological characterization of ovarian tumour was done according to the International Classification of Diseases, (WHO Classification, 1995).
Results: Age ranged 18- 28 years had 24, 28-38 years had 40 and 38-48 years had 10. Common non- neoplastic lesions were simple serous cyst in 13, luteal cyst in 20, salpingo-oophoritis in 3, hemorrhagic cyst in 8 and endometriosis in 6 patients. Common neoplastic lesions were germ cell tumor seen in 12, epithelial tumors in 6, sex cord stromal tumour in 4 and metastatic tumors in 2 patients. The difference was significant (P< 0.05).
Conclusion: Most common non- neoplastic lesions was simple serous cyst, luteal cyst and hemorrhagic cyst and neoplastic lesions was germ cell tumor.

Xylan papyrus was used as a base material for the bio-conversion of xylose into xylitol by the yeast Candida tropicalis, and xylitol was used by using the HPLC technique. xylitol was produced under different conditions and factors, the optimum temperature was 30 ° C, the best source of nitrogen was yeast extract, the best concentration of xylose was 60%, the optimum pH was 5.5 and the best ventilation speed was 150 rpm, so the highest concentration of xylitol was 50.8 mg / ml. using the above conditions.

Despite the intense research, the clinical manifestation of syndromic craniosynostosis patients remains an enigma. Human skull is made up of various bone joints connected by sutures. The sutures fuse in later life after the complete growth ofthe brain. If any of these sutures close early, it may encumber the normal growth of the brain. In craniosynostosis there are disturbances in the growth of the skull which are caused by premature synostosis at one or more cranial sutures, resulting in typical deformities of the vault called as dyscrania. Crouzon syndrome is an emblematic example of craniosynostosis. Cranial malformations in crouzon syndrome depend on the order and rate of progression of sutural synostosis. Thus, physical appearance varies from patient to patient. In this article we intend to compare two patients with crouzon syndrome and a clinically non syndromic patient with beaten metal appearance radiographically. The idea behind this is that each syndromic patient is distinctive and a separate approach for treatment of such patients is desired.

The epidemic of coronavirus disease 2019 (COVID-19) led to unprecedented outbreak in Wuhan, China; has become a major public health challenge for not only China but also countries around the world. The severe global quarantine efforts and social distancing were taken worldwide in response to this global outbreak. This has challenged the health professions and systems evoking heightened reactions around the globe as response to Covid-19. While most heavily impacted, the role of the dental professionals in preventing the transmission and responding to its long-term impacts on dentistry is crucially important. This review article, while outlining the essential knowledge about COVID-19 and nosocomial infection in dental settings, provides recommended strategies for dental practitioners to redesign dentistry to a new reality in a way to combat dental crisis to bridge the gaps in dental settings to overcome this emergency.

The behaviour of the eigenvalues of Dirichlet Boundary-Domain Integro-Differential
Equations (BDIDEs) with a reduced number of collocation points has never been
discussed theoretically. The uncertainty of the behaviour of the eigenvalues of Dirichlet
BDIDEs will prohibit the use of iteration methods in solving the BDIDEs system of
equations. The purpose of this paper is to demonstrate the spectral properties of matrix
operator obtained from the discretized Dirichlet BDIDEs with reduced number of
collocation points. We calculate the eigenvalues of the matrix operator, numerically. The
discussions of the spectral properties are based on the eigenvalues of the discretized
BDIDEs that are obtained numerically. In our numerical test, the attribution of the eigenvalues
for matrix operator obtained numerically for the discretized BDIDEs with reduced
number of collocation points exceeds 1. The findings demonstrate that it is utterly
impracticable to solve the system yielded from the discretized Dirichlet BDIDEs with a
reduced number of collocation points with an iterative method. The theoretical explanation
of why this behaviour occurs is also provided. With this result of the eigenvalues attained,
the matrix equations yielded from the discretized BDIDEs with a reduced number of
collocation points can purely be solved by direct methods.

In this paper, we solve a diet problem of McDonald’s sets menu in order to
find the optimal costs and satisfied the daily calories and nutritional requirements for a
person. The nutrient contents and price for each set menu of McDonald’s need to be
found. After that, by using the integer linear programming technique, we search the sets
menu of McDonald’s with the minimum costs while satisfying the calories intake by a
person is not exceeded 2500 Kcal / a day or 2200 Kcal / day. The mathematical model of
the problem is formulated as linear integer programming where the total cost for the
proposed set menu is the objective function. The constraints involved are the amounts of
calories, carbohydrates, protein, fats, salt and sugar. By using the Solver tools in MS
Excel, we solve this problem.

One of the main challenges in machine learning classification is handling
imbalanced data because imbalanced data can produce result bias towards the majority
class and a poor performance of classification. Therefore, in this paper, an improved
workflow is introduced to cater this issue. After combination of Synthetic Minority Oversampling
Technique (SMOTE) and Tomek Links or known as SMTmk method is
performed, additional step is required to further increase the performance of machine
learning classification especially in Specificity field. The step is completed by reducing the
number of majority class based on the ratio of minority class. Three machine learning
algorithms is used to test the classification result which are Extreme Gradient Boosting,
Random Forest and Logistic Regression. Result recorded in this research shows that the
ratio of 7 to 1 is better than the established methods which are SMOTE and hybrid method
of SMOTE and Tomek Links.

This research identifies the requirement used to visualize Air Pollution Index in
Malaysia (ApiMAS). Air pollution is a worldwide issue in the area of environment and
health, especially in developing countries, which calls for crucial part of governments to
implement solutions to solve air quality issues. Most people are unaware and not alert of
particle pollution levels that can affect their health. When pollution information is
incompatible, the lack of information sharing causes difficulties to the people. This
research focuses on the on-site of Kuala Lumpur. Data visualization is most suitable for
researchers to analyze, discover, and monitor performance through graphs, charts, or
pictographs that can represent the data for information virtualization. The Cross-Industry
Standard Process for Data Mining (CRISP-DM) model which is used as the methodology
has four phases including business understanding, data understanding, data preparation,
and modelling. This research output is an interactive design dashboard for information
visualization that is necessary for researchers, public users, and technologists. In
conclusion, interactive dashboard ApiMAS may assist its users with prolific knowledge
provided in the dashboard.

This paper proposes a concept utilizing a thermoelectric generator (TEG) device
to convert thermal energy different between ambient air and soil into electrical power. In
this study, soil temperature profile with three various depths has been studied to find the
optimum depth for maximum temperature differences between ambient air and the soil. The
study area coverage is at the lake nearby Universiti Kebangsaan Malaysia (UKM), Bangi
Malaysia. After the temperature data collected, the efficiency of TEG with different
configurations was tested in the lab. Then, energy storage devices and buck-booster are
used to further enhance the capabilities of TEG. All the models are then integrated and
tested to power up electronics load according to the temperature profile collected. The
results have proposed the depth of soil 20 cm will provide an optimal average temperature
different of 3.34 0C. Based on the temperature gradient data, combination of four TEG
TEP-12656 in a series connection with DC booster circuitDC1587 will produce an optimum
voltage output about 3 V. This output voltage is enough to fully charges small storage
system such as super capacitors 10 F in 6.58 minutes. Arduino Uno was used as a load and
it was successfully powered up for a short duration of time before energy fully depleted.

This paper reviews the development of the business intelligence (BI) platform in
the web application system based on the open-source content management system (CMS):
WordPress, Joomla, and Drupal. The open-source CMS mostly used by companies for their
websites and web application systems, while the BI application used by companies to
analyze the information needed for decision-making. The BI application involves data
visualization (DV) techniques that displayed in a visual chart or dashboard, which can
effectively improve the interpretation capabilities of data. However, the open-source CMS
cannot easily be integrated with commercial BI software, and most commercial BI tools are
expensive and require the purchase of copyright. In this study, the existing DV plugins,
extensions, and modules in WordPress, Joomla, and Drupal are reviewed and analyzed for
developing the BI application in the system. The aimed result for this study is to find out
which open-source CMS between WordPress, Joomla, and Drupal is the best used for
developing the BI platform in the web application system by using their DV plugins,
extensions, and modules.

In recent years, Artificial Neural Networks (ANN) was widely implemented for
developing predictive and estimation models to estimate the needed parameters. As the
Coronavirus disease 2019 (COVID-19) case numbers are rising internationally as
uncontrolled outbreaks, it is important to better understand what factors promote the super
spreading events. In this paper, the use of Multi-Layer Perceptron (MLP) and Radial Basis
Function (RBF) of ANN for COVID-19 spread and death contributing factors in America
was described. A comparison was made by using a dataset of COVID-19 cases and deaths
reported from 49 states in America during April 2020. Seven covariates used in the network
which are High Temperature, Low Temperature, Average Temperature, Population,
Percentage of Cases over Population, Percentage of Death over Population, and Total
Cases. However, the performance of MLP and RBF networks may be evaluated relatively
similar. It was found that both MLP and RBF proved that the Population, Percentage of
cases over population, and Total cases are the most contributing factors towards COVID-19
spread and death in America particularly.

This paper presents a study on minimising the estimation error of forecasting the
electricity consumption in Malaysia. A robust and accurate forecasts of electricity
consumption are deemed crucial for the supplier to arrive on fair estimations of electricity
supply optimally. Thus, identifying the best model to forecast the electricity consumption
accurately may hinder energy wastage. This research aims to examine which model gives
the least error in estimating the future electricity consumptions in Malaysia. Two models
were tested namely Artificial Neural Network (ANN) and Regression Methods. In analysing
these models, this research applies the Microsoft Excel and SAS Enterprise Miner (SAS)
software. The data were extracted from the Department of Statistics Malaysia (DOSM),
CEIC Data Company and The Statistics Portal. Results indicate that ANN produces least
error as compared to the Regression Method as the former fits the data well whilst the latter
overfits the data. The ANN model uses NNTool from MATLAB is used for forecasting
future electricity consumption. The forecasted values (2020-2022) proved to provide more
interpretable forecasts. This study may benefit the electricity supplier, consumers and also
the Government of Malaysia, in particular the Ministry of Energy and Natural Resources.
It may provide insights on estimating the optimum amount of energy to be generated. This
will definitely increase the savings and reduce wastage from every angle. Ultimately, the
environment is saved too.

Pyrazolopyrimidines and related fused heterocycles are of interest as potential bioactive molecules. The heterocyclic fusion of pyrimidine ring and pyrazole ring resulted in formation of pyrazolopyrimidines, the structural analogues of biogenic purine class, undoubtedly, has high significance in the field of pharmaceutical and biotechnological sciences with wide spectrum of biological activities and its several derivatives. Toxicity may be due to the accumulation in a specific organ/ tissue (e.g. bosentan), the co -administration of other drugs affecting ADMET (absorption, distribution, metabolism, elimination and toxicity) Cmax reaching off target IC50, or the high Cmax required for therapeutic effects. Assessing the relative drug efficacy and toxicity is important for medicinal chemists, pharmacologists, pharmacists, physicians. As multiple treatment options are available for many diseases, relative toxicity assessment is necessary. Difficulty in direct clinical trial comparisons forces network meta-analyses for estimating the relative toxicity. Therapeutic index (TI) assumes simplified linear relationships between receptor affinity, maximum unbound plasma drug concentration (Cmax) and toxicity. But high TI does not guarantee safety. For drugs metabolized by cytochrome P450 (CYP450),estimating TI based on target potencies alone is insufficient.

Grammar and vocabulary are two vital components that exist in English language. A good command on both of these would relatively make the use of the language better and attractive on the part of the listeners. But today students find it quite challenging to have an excellent hold or command in these areas of grammar and vocabulary and students often end up on a poor scoring scale either in the English subject or in competitive exams or in their professional careers. In order to have an experience and learn the problems faced by students on these two challenging areas an experimental study was conducted among degree students among a semi- urban college and after analysing the results,task-based learning activities were implemented for learning. The outcome and analysis from the teaching learning experience makes the source of this paper. The rapid development and progress among the students become the result of innovative teaching practices over traditional teaching and it shows the essentiality for implementing innovative teaching practices among language teachers. The outcome of the study showed a significant improvement in the performance of the students and also their receptiveness to activity-based learning method over the traditional method that was highly admired. The outcome of the TBL method can be seen through the post test scoring that has relatively improved the overall performance of the learners.

Endosulfan- one of the popular organochlorine insecticides was launched into the agricultural sector in the 1950s as a part of Green Revolution. Endosulfan was relatively inexpensive but offered high efficacy and stability that led to its extensive use as an agricultural pesticide in the global market for more than 30 years despite being labelled as a restricted Organochlorines (OC)-class agent. However, several cases of endosulfan poisonings started emerging periodically from many parts of the world. The most infamous chapter of endosulfan disaster is arguably the one that happened in Kerala- India over a span of 25 years. The aim of this article is to provide an in-depth overview of the tragic event and its outcomes, that contributed to a global ban recommendation of the dangerous pesticide.

The in-silico method is extensively utilized in the study of proteomics and genomics studies.
The T-cell epitopes prediction is essential step in the development of peptide -based
vaccines and diagnostic. The epitopes emanate as an emanation of intricate proteolytic
mechanism within cell. Proceed to being perceived by T cells, an epitope is presented on
the cell surface as a complex with a major histocompatibility complex protein. Henceforth,
T-Cell identified epitopes are excellent binder of MHC. Therefore detection and
identification of the MHC binders essential for target based study of drug. In recent study,
we analyzed D. medinensis antigenic protein peptide binders to MHC-I and MHC-II
molecules. The binding with MHC-I molecules are obtained with are 11mer_H2_Db,
10mer_H2_Db, 9mer_H2_Db, 8mer_H2_Db and for MHC-II are as I_Ab.p, I_Ad.p,
I_Ag7.p, I_Ak.p .

Diseases of the gastrointestinal tract are often accompanied by changes in
the oral cavity. This is largely due to morphological and functional unity of the mucous
membrane of the mouth and entire digestive tract. According to numerous publications in
recent years, at the end of the XX-beginning of the XXI century, there is a significant
increase in the number of people suffering from cancer of the colon and rectum. This
localization accounts for 15% of all initially diagnosed tumors of all localizations (30% of
them are represented by rectal cancer).

If in the control-green manure without crop experiment variants, the plant height was
80.6-79.1 cm, the yield horn was 14.2-14.1 pieces, the average joint spacing of the main
stem was 4.1-4.3 cm, the main stem thickness was 1.78-1.76 cm, when green manure crops
were applied, the agronomic soil properties and characteristics were positive for the plant,
coordinated the cotton growth and development, the plants were found to be relatively
vigorous and healthy growing and developing. This pattern was repeated in all
experimental years, and the data were observed in an analogous manner.
When green manure crops were applied in summer and autumn, the cotton
verticillium wilt incidence was reduced. This condition was observed throughout the
growth period. This, barley acted like rapeseed. For example, in the summer control-green
manure cropless variant, 4.9% of cotton plants were infected with verticillium wilt on July
15, 9.3% on August 1, and 13.3% on August 15, pea variant 4.5; 8.1; 12.4%, 3.8; 7.2;
11.8% in the chick-pea variant, respectively, raps variant 2.4; 5.1; 8.3%, barley variant was
2.7; 5.3; 8.9%.
In particular, in the fall, the control-green manure without crop variant was 5.8%
on July 15, 10.2% on August 1, and 14.8% on August 15, while the pea variant was 5.28.9;
13.1%, respectively; chick-pea variant was 4.8; 8.6; 12.1%, raps variant was 2.6; 5.3; 8.6%,
and 3.0; 5.8; 9.3% in the barley variant.
In the control-green manure cropless experiment variant, the yield was 35.1s/ha,
while in the green manure management variant 5.5-8.6 s/ha was obtained. In the
experiment, the highest yield (43.7 s/ha) and the most reliable additional yield (8.6 s/ha)
were obtained in the raps planted variant as a green manure crop, 42.8; 40.8 and 40.6 s/ha
yields were observed in barley, chick-pea and pea variants planted as green manure crops,
respectively.

Nanotechnology is the art and science of material engineering at the Nano scale size (1-100 nm). Nanotechnology consists of the process of separation, consolidation and deformation of materials by one atom or one molecule. It’s one often most popular areas of current research and has developed in multiple disciplines. Nanotechnology has been used in the development of restorative materials with significant success. This comprehensive review article highlights the importance of Nanotechnology in dentistry

Introduction: COVID-19 is the current global coronavirus pandemic caused by the SARS-CoV-2 coronavirus. The first reports of the disease outbreaks appeared in China on December 31, 2019 and the first clinical manifestations occurred earlier on December 8, 2019. On January 30, 2020, the World Health Organization declared the outbreak as a public health emergency of international concern. On March 11 it was declared a pandemic. Common symptoms include fever, cough, fatigue, shortness of breath, and anosmia (loss of smell).Complications can cause acute respiratory distress syndrome (ARDS) and pneumonia. The incubation period is usually around five days, but can range from two to fourteen days.
Aim of the research isto study of clinical and diagnostic criteria for neurological disorders and changes of laboratory parameters in patients with COVID-19.
Material and methods: We examined 31 patients who had undergone COVID-19 and were hospitalized at the private clinic "Neuromed-Service" named after academician N.M. Madjidov. There were 19 males and 14 females. The age of the patients varied from 18 to 75 years (the mean age made up 41 years).
Results: Patients with inflammatory diseases of the peripheral nervous system (neuropathy, facial nerve, trigeminal neuralgia), considering an increase of C-reactive protein were performed anti-inflammatory therapy with NSAIDs and steroids (Dexamethasone intramuscularly). In patients with convulsive syndrome EEG was monitored using the "Neuron - range 2" (Russia). Diffusechangesinthebioelectricalactivityofthecerebralcortexwererevealedinthestudiedpatients.Epiactivityinthefronto-parietalregionofthebrain (against the background of taking anticonvulsants)was also recorded. The dose of anticonvulsants was increased for these patients and decongestants were prescribed. An increase in fibrinogen was also noted in the blood of these patients. Conclusion: Thereby, in patients after suffering COVID-19, the blood tests showed an increase of fibrinogen by more than 2 times and an increase of C-reactive protein. All this testifies the fact that in these patients after treatment, at the alleged improvement of their condition, the blood continued the process of thrombosis strengthening and inflammation persisted in tissues and organs. In patients who prematurely stopped taking antiplatelet agents and anti-inflammatory drugs after illness, neurological and other complications were developed

The article discusses the theoretical and practical basis for raising the effectiveness of education in the institutions of continuing education to a new level through innovative activities of teachers.

Specialized advancement is firmly associated with the social and regular solace of society, with the degree of the necessities of present day society, however the interruption of creation cycles, the low degree of ecological administration culture, the garbled outcomes of its control over the encompassing scene, devastate the concordance of nature and people. The reason for the paper is coordinated to improve the expert preparing of alumni of higher instructive organizations, fit for taking care of creation issues with limiting ecological dangers. The creators uncovered academic ways to deal with natural instruction and proved the quintessence of the idea "biological culture of understudies". Instructive conditions that add to the arrangement of natural culture of college understudies are created, presented and test tried. The paper is planned for educators, heads of instructive associations, scientists managing natural security issues.

In modern conditions of education development, it is becoming a priority to train specialists with skills of professional and socio-psychological adaptation a changing world. Education is not only a vehicle for the most adequate clarification of the requirements of the new society and market economy, but also a way to achieve goals, form the creative, spiritual needs of the individual. The change in the paradigm of education is accompanied by the process of reorientation of the result of education from the concepts of "preparedness", "Education", "general culture"

Medical education is rapidly changing, influenced by many factors including the changing health care environment, the changing role of the physician, altered societal expectations, rapidly changing medical science, and the diversity of pedagogical techniques. Changes in societal expectations put patient safety in the forefront, and raises the ethical issues of learning interactions and procedures on live patients, with the long-standing teaching method of “see one, do one, teach one” no longer acceptable. The educational goals of using technology in medical education include facilitating basic knowledge acquisition, improving decision making, enhancement of perceptual variation, improving skill coordination, practicing for rare or critical events, learning team training, and improving psychomotor skills. Different technologies can address these goals.

The education of specific terminology related to natural sciences in foreign language classes can be difficult to deal with because of the complex vocabulary. However, with the right teaching methods and techniques, this objective can be met successfully. The following article discusses the ways to teach science students the relevant terminology and concepts in language classes.

Through a comprehensive program for the development of information and communication systems, distance learning and computerized conferences are being conducted in order to reform the continuous education system of the country, introduce information technology and improve the effectiveness of education. , the creation of distance learning systems and their introduction into the teaching and learning process. At the same time, there is a need to expand the scope of Web technologies in the learning process. The Strategy for the Strategy for the Development of the Republic of Uzbekistan sets out the tasks of "Creating the use of. information technology in educational process by means of new methods and tools" at the Higher Education Institutions, and improving the methodological bases.

The relevance of this study is determined by the needs of modern society for qualified specialists, which leads to the necessity of improving the system of higher education. This dictates the need for a high-quality preparation of the teacher of English who is able to act as an active subject of the professional activity and who has high levels of communicative competence.

In chronic experiments in laboratory animals, studied toxicological perspective new antidepressants Skimmianine for the treatment of depressive states, an original herbal preparation based on Haplophylum perforatum was created. During 6 months of intragastric administration in animals exposed to all doses of skimmianine, no deviations in the parameters of the functioning of the nervous system were found, therefore, this value is the lowest effective (threshold) dose in a chronic experiment.

Today the theory and practice of language and culture attracts more and more scholars, it has become evident that the investigation of its problems requires expertise from the different points of view of various areas of linguistics.

Allergy is a pathology of countries with a high index of socio-economic development and most of all residents of large cities. By 2025, according to the WHO, 50% of the world's population will suffer from allergies [14]. This article examines the main risk factors for the development of allergic diseases in children under the age of 18 in Tashkent. The most significant factors were: the presence of an inherited predisposition on the line of one (RCh 1.9) or both parents (OR 5.6), closely related marriages between parents (RCh 2.8), the age of parents over 40 at the time of conception of the child (RCh 1.4) and some others.

Purpose: This systematic review and meta-analysis was done to highlight the existing
literature and organize data associating the mortality of coronavirus disease 2019
(COVID-19) in patients with and without asthma.
Search criteria: The Scopus, Embase, PubMed, medRxiv. org and Google Scholar
databases were explored for studies associating the clinical results of with and without
asthmatic patients diagnosed with COVID-19. Mortality data were concise with the
Mantel-Haenszel OR with 95% CI in a random-effects model. Five retrospective studies
met the inclusion criteria. A meta-analysis of data from 1181 asthmatic patients and
8,847 nonasthmatic patients specified that the presence of asthma had no substantial
consequence on mortality (OR = 0.96; 95% CI 0.70–1.30; I2 = 0%; p = 0.79).
Result: Results were stable in a sensitivity analysis. A descriptive analysis of other
clinical outcomes designated no alteration in the duration of hospitalization and the risk
of intensive care unit (ICU) transfer between asthmatic and nonasthmatic patients.
Conclusion: Asthma may not upsurge the mortality of COVID-19.

Introduction: Malocclusion is commonly seen dental anomaly. Awareness regarding malocclusion among youth forms basis for oral health status planning.
Objectives:To assess awareness and knowledge regarding malocclusion among young adults.
Materials & Methods:The present study was conducted among 580 subjects age ranged 17-22 years of both genders. All subjects were thoroughly examined by a single orthodontic surgeon. Subjects were instructed to respond to the questionnaire which was given in their language.
Results:Out of 580 subjects, males comprised of 310 (53.4%) and females 270 (46.6%). 408 (70.3%) knew that beautiful smile adds to personality, 152 (26.3%) had no idea and 20 (3.4%) replied no. 435 (75%) were confident about their smile, 23            (3.9%) were not and 122 (21.2%) do not know. 255 (43.9%) were confident about their teeth, 300 (51.7%) were not and 25 (4.3%) do not know. 150 (25.8%) thought that crowded teeth can affect speech, 256 (44.1%) replied chewing and 174 (30%) replied esthetics. 290 (50%) replied that crowded teeth can cause gum problems, 180            (31%) replied cavity and 110            (18.9%) replied pain. There was lack of knowledge regarding braces and most of them never visited dentist.
Conclusion:Authors found that there was lack of awareness among adults regarding orthodontic need. There was lack of satisfaction level regarding the appearance of teeth.

The earliest procedure in unilateral cleft lip nose management was concenterated by Victor Veau in his book at 1938. He used simple coaptation of the margins of the cleft after they had been surgically exposed. The results obtained with this technique were unfortunately consistently bad for many reasons but mainly because of poor surgical reconstruction of the labial musculature. Through the principles done by Veau and more recently by Delaire, there has been a re-appraisal to concept of primary cheilorhinoplasty in unilateral cleft lip management. Senior cleft surgeons as Millard, McComb and Salyer provided encouraging results after reviewing the long term results of simultaneous repair. They proved that there was no interruption of growth by early surgery and reported stable results up to 18 years after surgery

Obesity is disorder in a foremost nutritional health it’s developed with countries developing. Also is known as increasingin fat accumulation that lead toproblem in health, besidesmay coin one of the reasons lead toloss of life,the obesity not effect on adults just but effect onoffspringand juveniles. In some ofinhabitants the incidence of obesity is superior in female than in male; on the other hand, the variation degree of the between the genderdifferby country.Obesity is generally measured by body mass index and waist circumference, Obesity are classified according to body mass index into:Pre obesity sort 1 : (25 - 29.9) kg/m2, Obesity sort 2 : (30 - 34.9 kg/m2) and extreme obesity sort 3: (40 kg/m2) or greater. Obesity is described by a pathologic condition with augmented overall of cholesterol, triglycerides, LDL cholesterol while reduced of HDL levels.There are many hormones causes pathophysiology of fatness such as adipokines, gutcorrelated hormones and ghrelin, numerous studies have revealed that the association among fatness and the metabolic sickness such as Insulin resistance, activity of lipoprotein lipase in muscle reduction and free fatty acids increasing. Conclusion: Obesity and overweight different between men am women according to quality of life in different population and countries

Phytotherapy continues to play an important role in the prevention and treatment of diseases (communicable and non-communicable). Amazingly, more than 80% of the global populations nowadays adopt phytotherapy as a basic source of maintaining good healthy conditions, owing to the pronounced side effects, non-availability, and expensive nature of conventional treatment options. . A number of medicinal plants had been resourceful (effective) against a range of diseases, with few developed into drugs based on the available phytotherapeutics, quite a large number of them are yet to scale through clinical trials to determine their safety and efficacy. The origin of the medicinal plants use had been since time immemorial and traced back to Europe and Egypt many centuries ago. The first records of knowledge documentation were, however, produced by Shen Nung (a Chinese emperor) 2500 BC ago, describing different recipes of drug preparation from 300 medicinal plants for the management of numerous human diseases (1).

In recent times, sleep disorders and associated breathing difficulties have received significant attention, leading to an increased interest in the study of various maxillary expansion protocols. MARPE has become progressively popular in the management of transverse discrepancies in comparison to traditional expansion methods, due to its augmented skeletal effects. Awareness of early prevention or methods to alleviate sleeprelated breathing disorder symptoms by possibly increasing the airway dimensions has led to an interest in the study of various maxillary expansion protocols. Literature on MARPE, its effects and techniques are quite scarce. This article aims to review the appliance design, miniscrew placement, activation technique and post- expansion outcome parameters and latest advancement in the customized digital manufacturing process

The marine water fishTrygonsephen collected from Ratnagiri district during the period of June 2017 to May 2018. After dissection their intestinal passage was examined for tapeworm parasite. The tapeworm, tetragonocephalum sp. Shipley (1905). The histopathological studies were carried out and observation clearly shows that the parasite, TylocephalumgovindiSp.Nov. was approaching to the intestinal villi, embedded in the fibroblast cell and is attached to the intestinal villi. Thehistopathological studies of tapeworm TylocephalumgovindiSp.Nov.Have been studied to find the pathological changes and extendof damage of the intestinal layers of Trygonsephen

The issues of constructing a mathematical model of a multistage process are considered using the decomposition method, dividing the general technological system into interconnected control loops. A procedure for constructing an integrated macro model of a multistage process using a system of material balance equations for each control loop is
presented.

The development of online transportation raises the question about the data processing of online application users. The data is passed on to the driver to run the service. Problems arise when the information is misused in violation of the law by drivers outside the context of providing services. This research aims to discuss online transportation application companies' responsibilities for the unauthorized use of user's data. This research is normative legal research. It uses secondary data. The study found that the application company should be responsible for ensuring the confidentiality of the data. Furthermore, the application company should share responsibility for the misuse of data obtained from the application enterprise.

Square measure of muscle contractions outlined by adjustments during contraction within the length of the muscle. We demonstrated some findings on common fastened points for more than one mapping through conditions of victimization contraction that may be relevant to muscle contractions. We have also developed some coincidence and ordinary fixed-point theorems that are the generalization of some well-known theorems.
Keyword: Fixed point, metric spaces, uniqueness, point of coincidence, mapping of commutes

Due to diverse climate in India, wide variety of green leafy vegetables can be found which are still unexplored and underutilized. In addition to being resilient and adaptive, these vegetables also demand low cost plantation and harvesting. Demand for sufficient food and nutrition has led to scout more of these vegetables.  A study was conducted to assess the anti-nutritional and phytochemicals profile of some underutilized and commonly consumed green leafy vegetables (GLV) to increase their acceptability in the daily diet. Amaranth (Amaranthusviridis), cauliflower leaves (Brassica oleracea var. botrytis), radish leaves (Raphanus raphanistrum subsp. sativus), spinach (Spinacia oleracea) and lettuce leaves (Lactuca sativa)[V1] were collected locally. The leaves were washed and tray dried in a hot air oven at 60°C for 2-3 h and ground into powder. They were tested for presence of phytochemicals and anti-nutritional components phytic acid, nitrate, oxalate, tannin, and alkaloids. Among the GLV cauliflower greens had the highest content of oxalate (97.78±0.02 mg/100 g) followed by radish leaves (84.5±0.02) and spinach (72.51±0.02), respectively.  Higher levels of phytic acid occurred in lettuce (26.89±0.02 mg/100 g), amaranth (25.79±0.02), and cauliflower greens (25.50±0.02). Tannin content was in cauliflower (37.79±0.03 mg/100 g), spinach (39.89±0.02), radish (42.54±0.02), amaranth (41.26±0.02), and lettuce (43.7±0.02). No differences occurred in nitrate content of all GLVs (cauliflower (12.44±0.01 mg/100g), radish (9.8±0.02), spinach (7.9±0.28), amaranth (11.86±0.01), lettuce (12.76±0.02). Alkaloid content of the GLVs was highest in cauliflower (72.81±0.01 mg/100 g) followed by radish (68.09±0.02) and lowest in lettuce (48.8±0.02). The GLVs offer cheap, rich sources of several phytochemicals. Phytochemicals are considered to be new form of medicine inducing health. The anti-nutritional content is of no consequence and may be reduced by various processing and cooking methods. Without any interference from anti nutritional factors, greens can be tapped to their maximum potential.  These underutilised greens can be developed as value-added food products but mostly greens serve as fodder for animals and is wasted. This study proves that the beneficial extracts from these underutilised green leafy vegetables can be used as rich sources of micronutrient and phytochemicals in our daily diet.



 [V1]Provide naming authorities.

Background: Lichen planus (LP) is a common disorder whose etiopathogenesis is not clear.Recently, it has been suggested that increased reactive oxygen species (ROS) play important roles in the underlying mechanism of LP. Free radicals have an important involvement in the underlying mechanism of lichen planus and also various skin diseases. The aim of the study was to evaluate serum uric acid (UA) levels as a measure of the antioxidant defense status in lichen planus patients.
Methods: A case control study was performed on 17 patients with lichen planus and 17 healthy subjects as a control group. We estimated Serum level of uric acid and ascorbic acid using ELISA.
Results: The mean of serum levels of uric acid and ascorbic acid was lower in patient group compared to healthy group with no significant difference between the two studied groups.
Conclusion: Lichen planus pathogens are not specifically affected by antioxidants as uric acid and ascorbic acid. However, in addition to other interactive variables, the difference in the level of serum for these anti-oxidants between lichen planus patients and healthy subjectsalbight not important– may suggest their involvement.

Installation of distributed generation (DG) in distribution system has been favorable among them due to its great
impact on power system operation. However, improper installation of DGs will lead to under-compensation or overcompensation phenomena. Thus, a reliable optimization technique is required to address this problem. This paper proposes a hybrid cuckoo search evolutionary programming (HCSEP) based technique for renewable energy
distributed generation (REDG) and battery energy stored (BES) for loss and voltage stability control in power system. This technique integrates the operator in cuckoo search algorithm into the traditional evolutionary programming (EP) technique to alleviate the setback experienced in both traditional techniques. The proposed technique determines the optimal allocation and sizing of multi-units of DG and BES to address the loss minimization and voltage stability control. Validation on the proposed technique on the IEEE 30-Bus Reliability Test System (RTS) managed to produce convincing results and could be beneficial to the utility. Comparative studies conducted between the proposed HCSEP and the traditional EP highlight the superiority of the proposed HSCEP.

This scientific article describes the changes in immune parameters in the blood caused by acute polymorphic psychotic disorders and measures to optimize the treatment algorithm by treating them with immunomodulators.

This research paper provides design training at Russian language lessons at Tashkent State Agrarian University in conditions are created under which students independently and willingly acquire the missing knowledge from various sources and develop research skills in particular, the ability to identify problems, collect information, observe, and conduct experiment, analysis, hypothesis and generalization

Objective of the study: The purpose of the study was to compare stress level, basketball performance and menstrual distress in during and post menstrual phases among the university level female basketball players. The relationship between stress level, basketball performance and menstrual distress was also ascertained. Method: A total 80 girls were purposively selected as subjects from different colleges of Punjabi University, Patiala. All the subjects were assessed for stress, basketball performance and menstrual distress in during and post menstruation phases of menstrual cycle. The stress level of subjects was measured with the help of Perceived Stress Scale
(PSS) developed by Sheldon Cohen (1988). Menstrual distress was assessed by using the Menstrual Distress Questionnaire (MDQ) developed by Rudolf. H. Moos (1969).Basketball performance was assessed with the help of Johnson Basketball Test Battery design by L. William Johnson (1934).
Results: Paired sample t-test revealed that the basketball players had significantly (p<0.05) higher mean value on perceived stress scale in during menstruation phase as compared to post menstruation phase. Menstrual distress, pain and concentration were found to have significantly higher mean values (p<0.05) in during menstruation phase among basketball players. Behaviour and arousal were significantly (p<0.05) associated with perceived stress and control significantly associated (p<0.05) with basketball performancein post menstrual phase.
Conclusion: The performance of basketball players was not affected during the menstrual phase. Behaviour and arousal showed significantassociation with stress level and control was observed to be significantly associated with basketball performance in the post menstrual phase.

Dental caries a dynamic disease, is an important dental public health problem and is the most prevalent disease of oral cavity among children in the world*. This disease not only causes damage to health but is also responsible for several morbid conditions(such as periapical abscess, periapical granuloma ,Cyst) of the oral cavity and other systems of the body****. Although the prevalence of caries is declining ,mainly because of the wide spread of fluorides ,there still remains a subgroup of susceptible children at high caries risk. The dental caries usually starts in childhood and is undetected till adult life leading to complications and tooth mortality. Dental caries is a multifactorial disease influenced by many factors including age,sex,diet,microorganisms,oral hygiene etc. The present study was performed in order to analyze these factors which can help to plan preventive strategies for children.

Better understanding is provided by the digital twin about the performance of your product. With the help of advanced simulations, Manufacturing, Development and Design can be enhanced. For securing the future profitability and also for avoiding risks, your business must be transformed. Daily increment is observed in the amount of data that businesses have to act. Reports, statistics, feedback, product performance reviews, trends, customer/user feedback. The significant success factor is interpreting and sharing of data. For the digital transformation of product management process, various different aspects are reviewed in this paper. In this paper, the aspects are also observed as well as studied.

One of the biggest revolutions of modern history is the invention of agriculture for a healthier lifestyle. It significantly changed the human culture and played an important role in the development of the population and biological improvements in food production and domestication. Study into agriculture is then planned by improving the disease diagnostics method with the use of newer information technology to enhance efficiency and quantity for agricultural production and its allied operation. This project focuses on the identification and diagnosis of plant leaf diseases of tomatoes and pomegranate based on visual symptoms, anthracnose, and powdery mildew. Machine learning and image processing using SVM, KNN require many steps to identify and distinguish disease signs

Various opportunities in “Word-of-mouth communication” are provided through “web based technologies”. Through extensive use of “electronic commerce shopping communities”, the technique of communication of customers as well as product detail sharing with several other techniques is transformed. In the field of academic researches, it was observed that area of “e-commerce shopping communities” has remained unexplored. “Customer’s buying decisions” is greatly influenced by the online reviews shared by their customers. These reviews provide importance to the “concept of word of mouth”. In social media platform, YouTubers have already achieved a status of biggest influencers with loyal audience to support them. Therefore, with the enhancement in YouTubers’ fame, companies
are focusing on targeting new audience and to also gain more visibility of their respective brand. The YouTube videos and their effects are combined together to study its effects on purchase intention of consumers, new factors in YouTube are also introduced in the present study.

COVID-19 has been such a disaster which cannot be erased from the history. It changed the perspective of human race in every way. Medical agencies are on their knees and millions of people have lost their lives. Preventive measures like social distancing, wearing masks, sanitization, etc. have changed the lives of people. It also has affected the businesses of all types in the whole world and in addition, the behaviours of the consumers have also shifted in a very undefined and unpredicted way. This paper is to review this shift of the consumers’ purchasing behaviour and to understand its effects over the strategies of the business industries

Nowadays, neuroendocrine symptoms following twin brain injuries (twin brain injuries) are more common and negatively affect the outcome of Brain Double Injuries by reducing the overall quality of life. However, research from the scientific literature suggests that neuroendocrine dysfunctions, particularly hypopituitarism, play an important role in the etiology of complications. It has been found that postoperative hypopituitarism has been a clinically common phenomenon in the last twenty years and is likely to contribute significantly to these disorders, given the parallelism of adenohypophysis among those following neuroendocrine changes associated with hypopituitarism other than cerebral palsy. In this our scientific study, we sought to explore hypothesized pathophysiological mechanisms based on neuroendocrine anomalies after a Brain Double Injury through an overview, improved on the basis of an analysis of early diagnosis and treatment aspects

There is no specific research on the ontogenetic structure of cenopopulations of Spiraea species in Uzbekistan and the assessment of their current status. Our research was conducted in 2015-2019 in different parts of the Turkestan mountain range and studied the ontogenetic structure of 9 cenopopulations of S. Hypericifolia. The study analyzed the age structure of S. Hypericifolia in different cenopopulations. It was noted that the cenopopulations recorded during the study were specific to the left-sided and centralized spectra.

This article describes in detail the technique of performing total hysterectomy and its optimized version. Thanks to the optimized version of total hysterectomy, interoperative blood loss decreased by an average of 340.0 ± 60.0 ml, the operation time was reduced by 32.0 ± 4.0 minutes, thereby improving the outcome of the operation in 78 patients with massive obstetric bleeding

Online learning and online classes have been widely elevated to replace customary face to face methods of learning during this Covid-19 pandemic to keep up small kids learning and play at home. This research works overviewed 183 Indian parents’ attitude and perception for young children’s online learning during the lockdown of the Covid-19 pandemic. 10 different schools were selected for the study. Survey method was used to collect primary data. SPSS (version 24) was used to convert this primary data into information so as to draw a conclusion. With anobjective to understand the parent’s perception and opinion about online classes, it was concluded that parents are very well adjusted and satisfy about this methodology of learning. They opined that online learning has a positive influence on learning on the children and it is the need of the hour during this pandemic.

Covid-19 epidemics started in china due to corona virus and rapidly spread all over the world.This study is mainly focused to access the stress conditions of the people of India on their mental health andthe various issues faced in their day to day activity due to travel restriction in COVID-19 Lockdown. The work has been focused on the various factors like anxiety, watching the news related to covid-19 on television, difficulties faced out due to travel restrictions in medical emergency condition or in some common medical issues and the stress due to financial instability. An online survey wasconducted using snowball samplingtechnique. A total of 347 responses were received within the 10 days. Bilingual google form was circulated to cover maximum people through the online. The online survey result shows that the 46% of the people faced the stress due to financial instability, 27% people were reported that the stress due to anxiety and 19% people were depressed in the lockdown.

Epilepsy is a disease categorized by a spontaneous repetition of unprovoked seizures, is one of the most widespread chronic neurological states. the rate of its prevalence is reported to be 0.7–1.0% (Fiest, Sauro, Wiebe, Patten, Kwon & Dykeman, 2017). The Center for Disease Control and Prevention (CDC) proposes that neurological comorbidities, including epilepsy, could be a risk factor for COVID-19(Kuroda, 2020). The concern of the COVID19 pandemic toward patients with epilepsy include the fact that Frequent seizures would cause malnutrition, and the nutritional status is associated with the immune system (Crepin, Godet, Chassain, Preux&Desport, 2009). On the other hand, going to emergency rooms because of increased or uncontrollable seizures could expose the patient to coronavirus. Therefore, it's crucial to consider innovative ways to detect and control seizures among these patients.

The present investigation aims to evaluate anticancer activity of methonolic extract of Solanum xanthocarpum fruits. The extract is investigated for its inhibitory effect on MCF7, HeLa, A549, CaCo2 cell lines. Percentage viabilities of cell lines are assessed by adopting the MTT method. The extract has significant cytotoxicity on MCF 7, HeLa, A549, CaCo2 cell lines in the concentration range between 10 to 100 µg/ml. as per MTT assay. IC50 values of Solanum xanthocarpum on MCF7, HeLa, A549, CaCo2 cell lines are   27.99, 75.55, 54.66 and 156.36 respectively. From the performed assay, methanolic extract has more cytotoxic effect on MCF 7 and least activity on CaCo2 cell line. Thus the extract of Solanum xanthocarpum fruits has identified to have anticancer activity

Background: Unrecognized transection of the recurrent laryngeal nerve (RLN) or its motor branch could result in an unexpected permanent palsy. So, for a safe thyroid operation, intraoperative assurance of anatomical and functional RLN integrity is a necessity. Aim of work: To evaluate the recognition and protection of RLN by staining the RLN intraoperatively with methylene blue (MB) in one side and comparing it with the identification alone in the other side visually during total thyroidectomy. Subjects and methods: A case control study (retrospective study) carried out in the department of surgical oncology Zagazig university hospitals and Ismailia teaching oncology hospital during the period from November 2018 to August 2019. The study included 112 patients with bilateral thyroid disease who will do total thyroidectomy. The patients were subdivided into two groups depending on the MB use. Complete history taking was taken from all subjects. General examination of all body systems and local examination of the neck were done. We also did full lab investigations, neck U/S then the operations were performed. Results: We detected transient vocal cord palsy 10 sides (8.6%) of visual  identification alone, while in MB sides no case was detected with the same lesion. Conclusion: Recognition of RLN intraoperatively by MB staining is cheap and widely available technique and can decrease the stress during thyroidectomy, especially when Intra Operative Nerve Monitoring (IONM) is absent.

Background: Sudden cardiac death in the young adults is rare but it is tragic .It affects five per 100,000 yearly according to some studies. Nonstructural heart diseases that cause sudden cardiac death include long QT syndrome, short QT syndrome, Brugada syndrome , catecholaminergic polymorphic ventricular tachycardia ,idiopathic ventricular fibrillation (IVF) , AV node block , preexitation syndrome, and recently Early repolarization .Fortunately some these nonstructural heart diseases can detected by resting ECG.[1] [2]
Methods: In this study we collected a random sample of students from Zagazig University Student Hospital (during general examination during the application for the university) and university student accommodation in August and September 2017.Our sample collected was 2000 students ,800 met the inclusion criteria 474 were females and 326 were males ,the mean age was 18.42 ± 1.1.
Results: Males have significant more prevalence of early repolarization, LVH, RAD, LAD, wide QRS and sinus bradycardia than females. Female have significant more prevalence of short PR, low voltage and sinus tachycardia. Athletes have significant more prevalence of early repolarization, RAD, wide QRS, LVH, sinus bradycardia and long QT than non-athletes.
Conclusion: There is a variation in prevalence of ECG abnormalities between males and females, athletes and non-athletes like in early repolarization, LVH, RAD, LAD, wide QRS, sinus bradycardia, sinus tachycardia, long QT, short PR, WPW and low voltage.

To deepen our insight into the evolution of a threat situation, study of cyber incident data sources is an essential process. This is a relatively recent subject for science and many experiments still have to be conducted. Throughout this article, we present statistical analysis of the 12-year cyber hacking operation (2005-2017) violation incident data set which includes attacks bymalware. We prove that, in comparison to the literary results, breach sizes and inter-arrival times for hacking breaches can be modeled instead of distributions, since they have an auto-correlation. In order to adapt the time of the intercom and the scale of the violation, we suggest complex
stochastic process models. We also prove that the inter arrival periods and the violation scale can be estimated from these models. We perform quantitative and qualitative pattern research on the data set to achieve a better understanding of the growth of hacking infringement incidents. We derive a variety of observations into cyber security, including the challenge of cyber hacking in its scale, but not in its severity.

A comprehensive study is undertakenon the functional development of brain in Autism Spectrum Disorder (ASD).Brain functionality trajectories are unique in autism spectrum disorder .Autism spectrum disorder (ASD) is a set of neuro developmental disorders characterized by a deficit in social behaviors and nonverbal interactions such as reduced eye contact, facial expression, and body gestures in the early childhood days till the age of three. It is not necessarily a single disorder, and it is broadly considered to be a multiple disorder resulting from genetic and non-genetic parameters and their interpretation. Hereditary study of ASD has acknowledged mutations that interfere with typical neurodevelopment in womb through childhood. These DNA complexities of genes have been involved in synaptogenesis and axon motility. Recent developments in neuroimaging studies have proved many vital perceptions in vivo into the pathological changes which occur in the patients’ brain with ASD. Amygdala plays a majorrole in the limbic system and the affective loop of the cortico-striato-thalamo-cortical circuit, in cognition and ASD has been proved invarious neuropathological and neuroimaging research findings. Besides the amygdala, the nucleus accumbent is also considered as the vital ingredient which is related with the social recognition response in ASD. Although educational and behavioral treatments have been the mainstay of the management of ASD, pharmacological and interventional treatments have also shown remarkable benefits in subjects with ASD. Also, there have been implications on few patients who experienced through one of the interventional treatments resulted improvement after deep brain stimulation. The key architecture of ASD development which could be the focus for intervention is still an untapped destination. Further work is needed to explore the horizons on the grey trajectories on ASD.

Noncommunicable Diseases (NCDs) are one of the major health challenges, which has caused global concern due to their magnitude and high social cost. Industry 4.0 will significantly bring in IoT in the healthcare sector in an age of great growth in connected devices (up to 100 billion by 2030). The COVID-19 pandemic further accentuates the importance of using IoT in healthcare settings for both the providers and NCD patients due to controlled movements and enforced self-isolation throughout the world including Malaysia. In this regard, the improvement of “connected devices” has had a remarkable effect upon the entire healthcare sector and has been noticeably appreciated in “remote clinical monitoring”, “chronic disease management”, “preventive care”, and “assisted living” for senior NCD patients. This study intends to interpret the significance of IoT in connection with wearable technologies and digital healthcare. The study discusses several benefits of IoT like reducing cost, rising profits for the healthcare service providers in Malaysia, a higher level of success and productivity, and precision of “health monitoring and treatment systems”. The insights of this study will help the elderly NCD patients’ community and healthcare providers to recognise the significance of IoT Enabled Health Monitoring and Assistive Systems due to their significant contribution to improving healthcare in the country in the long run.

In quest of some anti-Novel corona activity  drugs, molecular docking studies with
PDB ID 6LU7  were carried out using certain well known chloroquine and its  derivatives viz  Hydroxychloroquine  Mefloquine. Molecular docking has been done in order to search the best drug candidate among chloroquine derivatives. The molecular dockings were done in Argus lab. Molecular docking studies revealed that chloroquine found effectively inhibit the recently emerged novel coronavirus . The docking score for chloroquine, Hydroxychloroquine  Mefloquine found to be -8.55665, -8.30357, -7.98409 respectively. Chloroquine  is found to be best drug candidate among its derivatives with docking score of  -8.55665.

The fermentative study on optimization of lactic acid production from cane sugar molasses by isolated Lactobacillus bacteria have been carried out to assess the most suitable condition for its production and to obtain high yield. The study on the optimization effect of different process parameters such as pH of the medium, temperature, inoculums size, incubation time and agitation rate were done in order to enhance the conversion of cane sugar into lactic acid. Optimization was done for Initial pH, temperature, inoculum size, incubation time and agitation rate. The optimum condition was found for fermentation with the process conditions of pH (8.0)  temperature (40 °C) and inoculum size (7% (v/v)) with an incubation time of 144 h and effective agitation speed of 175. The above mentioned optimized process parameters can be used in large scale production of lactic acid fermentation in further investigations by using cane sugar as a substrate .

The growth in internet of items (IoT) use in big data is exponential, and a large number of these devices are expected to be monitored in various domains for different applications. Therefore, high traffic volumes and safety standards and procedures must be managed by the servers. Although many mechanisms are in place to protect the data transmitted, they are not enough to satisfy the data requirements. This work therefore aims to enhance the security and privacy of IoT communications among big data through the implementation of server privacy and the development of unique signatures using device attributes.These features may be constant depending on the user, but when the device communicates, identity changes to protect privacy. To allocate IDs based on the IoT device attributes, a special server called the Attribute Management System (AMS) is used. Depending on data type and transfer length, three different algorithms are used. This latest, secure IoT device design communication offers safe big data confidentiality.
 

Background: The main goal of flexor tendon surgery is to restore digital motion by providing
tendon healing and preserving tendon gliding. The formation of peritendinous adhesions around
the repair site is one of several adverse events that may prevent achievement of this goal Flexor
tendon injuries occur frequently, adhesions between the tendon and its sheath are the most
common complication after tendon repair. The using of venous graft as a tendon sheath
substitute following tendon repair is a new technique for managing tendon injury that may
improve the result of existing method [1, 2].
Methods: In this study twelve patients were seen within 6 months in Plastic Surgery Unit,
Surgery Department, Zagazig University Hospital, and El-Ahrar Teaching Hospital in Zagazig.
However, no patient escaped or was excluded from the study. Those 12 patients were selected
among the cases of hand trauma coming to the hospital with Pure Flexor tendon injuries to
assess our study without affecting other injures ( orthopedic, vascular and nerve injures).
Results: All patients were assessed using the total active motion (TAM) scoring Final
assessment after a follow-up period of 6 months revealed excellent range of movement in two
cases, good range of movement in 10 cases and good result in 2 cases.
Conclusion: the use of autologous vein graft as a replacement of tendon sheath has many
advantages like; it is not expensive, being autologous so not carrying the risk of infection,
also it will not affect the tendon healing like other materials. It also improves tendon
nourishment.

Endometrial cancer is counted to be the most common gynecological malignancy and it is usually diagnosed at the early stages of the disease .Cancer staging main target is to help clinicians in making the decision for best management of cases and to guide treatment plan. Surgical staging includes; hysterectomy, bilateral salpingo-oophorectomy, and estimation of regional LN involvement, specifically the pelvic and aortic lymph node. Some instructed that lymphadenectomy clarifies the risk of recurrence and helps clinicians make the decision to give adjuvant treatment to high-risk patients. While, some suggested that, complete pelvic and para-aortic lymphadenectomy itself is associated with major comorbidities. Sentinel lymphadenectomy has been suggested in the staging process of the diseases with fewer traumas has considerable appeal.

Many researches about English language have been conducted by many researchers related to pronunciation errors by English learners around the world. This research investigates the errors of English
pronunciation made by Indonesian college students in Indonesia. This research uses qualitative method with
purposive sampling data. Data have been collected from 50 students of Gunadarma University, Jakarta. In
collecting data, the researcher typed the mispronounciation words as well as recorded their voice while they
were speaking in front of the class. It is found that: 1) English language has many different sounds for a vowel
letter (for example: letter „a‟ pronounced as [æ], [ɒ], [ə], etc.); 2) Indonesian language does not have silentconsonant
and silent-vowel letters (for example: silent g, h, k, and e); 3) The plossive consonant letters are not
pronounced clearly in bahasa Indonesia such the word tidak, bebek and sebab, etc. Thus, the Indonesian students
have problems the English words such as think, philosophy, psychology, bright, etc. In conclusion, many college
students in Indonesia are confused to pronounce some English words because they have such inconsistescy
sounds for vowel letters, vowel-letter combination, silent letters and the sounds of two or three combination of
consonant letters. This research is hoped to be very helpful for English teachers especially for teaching TEFL
(Teaching English as a Foreign Language) to help their students increasing their undertanding as well as their
pronunciation skills in speaking English. This research may be helpful for English teachers who want to design
some teaching methods to overcome the English pronunciation problems faced by college students in Indonesia

Today, the focus on the health promotion and disease prevention is stronger than ever been. Many diseases, especially chronic noncommunicable diseases are the main cause of the death and disability. Nevertheless, the main risk factors associated with chronic diseases are largely preventable by the health promotion. This was provided compelling evidence that addressing those risk factors is an efficient performance of the management policy, patient assessment, patient information and intervention, promoting a healthy workplace, and continuity and cooperation. In other words, these are the factors that have positive impacts on the disease prevention. This study aimed to evaluate the effect of health promotion on disease prevention. This study is based on the definition of health promotion and used the five dimensions theory of health promotion, the standards for health promotion in hospitals, and make some adjustments in the context of the health care providers. The scale was appropriately designed to be applicable in many health care contexts, with a particular focus on health care in the context of the rapidly growing private health facilities (PHFs) in Vietnam. The study found that the management policy, patient assessment, patient information and intervention, promoting a healthy workplace, and continuity and cooperation had positive effects on the disease prevention. The results of this study are an important foundation to propose policy measures to advance the health promotion, and contribute the disease prevention at the HCPs in Vietnam.

: As IOT has  rapid development by 2020, the role of wearable devices plays a crucial role in daily life.As the name implies wearable devices can be worn on our skin.There are different types of wearable devices which are available in the market like fitbits, smart watches, head mounted displays, smartjewellery,smart clothing, smart health.During COVID-19 pandemic period these devices are used extensively. The main objective of this research is toprovideawareness ofthe role played by these devices in COVID-19 period.These devices are used in detecting symptoms of COVID-19 and help the patients in providing required medication. The information obtained from the patients is stored in the cloud  using IOT. With this data the doctor candiagnose the patients condition and provide the required treatment.The data obtained from patients like their pulse rate, oxygen levels, etc  isstored in the cloud.

Nowadays monitoring individual’s health day to day has become an important concern in view of Covid19. It would help us to diagnose some changes that could happen inside a human body. Two of the important parameters that could be monitored are the internal temperature level and heartbeat of a person that could be made a part of an IOT system. This is used to monitor the health of a person. The objective ofthis paper is to build a structure for understanding the health care system and to provide treatment for patients. The theme of this paper is to build a framework organized for the survey of health professionals and to give answers for patients.
 

COVID-19 lockdown restricted movement throughout the world. The whole world was quarantined and a large number of populations faced stressful situations in other aspects of daily life such as unexpected economic downturn, the higher burden on non-communicable diseases, lifestyle changes, various mental health issues, etc. There was a need for innovative and unique solutions to help and address the critical shortage of healthcare providers not only for those who were infected with COVID-19 but also for those who may require medical attention. During this critical situation, telemedicine services resurfaced and become an asset, with greater importance to the health-care delivery spectrum. The rate at which implementation of telemedicine services are occurring throughout the world, it becomes necessary for the organizations to understand the needs of the people who opt for such services. While several healthcare providers and systems have turned to telemedicine to maintain contact with their regular patients to minimize their risks of direct contact, the rate of adoption of this technology among patients hitherto accustomed to face-to-face consultation is uncertain, particularly in developing countries like India. The adoption can be measured with help of five variables i.e. Availability, Affordability, Accessibility, Accommodation, and Acceptability.Aims and objectives:
The purpose of this study is to analyze impact of COVID-19 pandemic on telemedicine services provided post onset of pandemic in the year 2020. The study intends to evaluate these changes with help of five dimension of healthcare access to namely Affordability, Availability Accessibility, Accommodation and Acceptability and how the telemedicine services have been in use to provide the remote healthcare to the patients in need during this period. 5A’s of Telemedicine will be assessed thoroughly based upon the set parameters and from the perspective of end user of the telemedicine i.e. patients, with the help of structuredquestionnaire.The study, therefore, attempts to evaluate the 5A’s of telemedicine from the patient perspective during the pandemicperiod.
Result:
Majority of the respondents either strongly agreed or somewhat agreed all the 5A of telemedicine has improved during this pandemic.
Conclusion:
Affordability of telemedicine has improved post pandemic and has become cost effective owing to reduction in travel and reimbursement for telemedicine consultation. In case of availability of telemedicine has improved with respective to specialty consultations and more hospitals have opened telemedicine post pandemic in order to keep up with their foot fall and revenue. Accommodation with respect to languages, user friendly apps has been found very useful during pandemic. Accessibility has seen tremendous improvement due to the availability of smart phones and hi-speed internet. Finally, all the above factors have helped to improve the acceptability of telemedicine during this pandemic situation

Pain in the lower back is the most urgent problem of neurology. The cause of back pain can be premature aging and wear of the intervertebral discs, as well as developmental abnormalities, autoimmune reaction to the disc tissue, etc. However, vascular disorders, especially the venous system in the area of spinal nerve segments, have not been sufficiently studied. The paper considers the use of the Doppler mapping method to determine the indicators of regional blood flow in the affected areas and the possibility of using the drug L-lysine escinate in the complex treatment of lumbar dorsopathies. Doppler framing in dorsopathies can reveal a disturbance of regional blood flow in the affected areas. Complex medical treatment with the inclusion of L-lysine escinate restores regional blood flow with subsequent porlanization of peripheral blood parameters, which contributes to a more rapid regression of neurological symptoms.

The article presents health of human beings and education of health generation on the basis of great state. - Healthcare reforms is one of the main areas of state policy, Shavkat Mirziyoyev said. A particular attention is paid in our country to further improving the healthcare system, stimulating the work of medical workers, wide introduction of modern technologies and treatment methods.

The review presents current data on the role of the immune system in the development after surgical complications during endoprosthetics hip joint. Surgical stress, exerting different powers oppressive effect on the immune system is a powerful factorcreating the preconditions for the development of secondary immunosuppression or- aggravating it against this background, the likelihood of postoperative complications are enough high. The conducted research has established the involvement in the process: osteogenesis and bone resorption Polypeptide growth factors - cytokines. The use of immunological methods allowed researchershighlight: criteria and develop ways to predict development complications in arthroplasty, the results were analyzed endoprosthetics of the hip joint in overweight patients body.

Chronic heart failure (CHF) remains one of the most important problems in cardiology, despite the availability of various modern diagnostic methods and a number of advances in treatment. This is due to its widespread use, lowering the quality of life of patients, as well as high rates of recurrent decompensation and death. Despite the optimal use of modern treatments based on proven medical principles, the disease still has a high morbidity and mortality rate (5,6,7,9,10).

Aging impairs the central nervous system capability to process vestibular, visual and proprioceptive signals responsible for maintaining body balance. Total hip replacement (THR) is a procedure, which can improve the quality of life in osteoarthritic patients. However, dynamic stability deficits and impairment in lower limb can be observed for several months after the procedure. Purposes: to investigate the effect of dynamic balance training and traditional rehabilitation on hip musculature moments, and stability index in unilateral total hip arthroplasty programming.

To study the clinical profile, etiology and various patterns of Macular Oedema. Materials & Methods: A cross sectional case study was done from December 2018 to May 2020 at Krishna institute of medical sciences, Karad. Detailed history and examination of the patients done including Amsler Grid, Color Vision using Ishihara’s Chart and Slit lamp 90D examination and dilated fundoscopy. Pattern of macular oedema was evaluated and subsequently documented using Fundus camera, OCT and FFA.

Non-invasive cardiac examination in standard clinic is still using 12-lead electrocardiograph. The results of the examination are presented on ECG paper or on the monitor screen. A normal electrocardiogram on one lead is not necessarily normal for the other lead, because each lead represents a certain part of the heart so that one by one is necessary. This examination takes time so that it can increase the stage of the disease if the patient turns out to be in an abnormal condition. This paper aims to correlate the peak amplitude of each lead to normal and abnormal heart conditions. If it is known that the peak amplitude is correlated between the leads, the other leads do not need to be checked, so that the diagnosis time will be obtained faster. Cardiac biosignal data that has been sampled with a frequency of 250 Hz is a discrete signal that can be stored digitally in a database. 10 samples of normal conditions and 10 samples of abnormal conditions were analyzed using Saphiro-Wilk so that the data were normally distributed. Spearman correlation analysis is used to get peak amplitude correlation between leads. The results showed that for abnormal conditions with a significance of 0.01 there was a correlation between the peak P lead I with leads III and V5, while for normal conditions there was a correlation between peak P lead I and leads V3 and V4. In abnormal conditions there is a correlation between peak R lead II and V6, while in normal conditions there is a correlation between peak R lead I and aVF.

Aim: Current study designed to identify whether the combination of vitamin C, hydrocortisone, and thiamine, to decrease the mortality and free of vasopressor administration in patients with septic shock.
Method: An open-label, randomized Quasi experimental study conducted in 240 cases of sepsis at intensive care unit for the duration of 3 years. Standard care group consists 120 and Interventional consists 120 (Standard care with Hydrocortisone, Vitamin C, and Thiamine). The primary endpoint hospital survival and secondary outcome the duration of vasopressor therapy and other outcomes were measured.
Result: Among 240 patients who were randomized, the primary outcome measurement recorded as 3cases (1.25%) in Interventional and 31cases (12.91%) in Standard groups. All patients in the interventional group were weaned off vasopressors with a mean of 17.5±10.2 hrs after starting treatment with the vitaminC+thiamine+hydrocortisone infusion. The mean duration of vasopressor use was 35.8±21.5 h in the standard group (p=0.001); 25% patients in the standard group received higher dose of vasopressors and died due to refractory septic shock. The mean duration of vasopressor treatment is 61.4± 33.8 h in the control patients who died compared with 39.5±12.5h in those who survived. The median length of Hospital stay is 13.64 ± 9.04 (4-80) days in the interventional group compared with 10.28 ± 5.93 (2-28) days in the control group. Conclusion: Early use of intravenous vitamin C, together with hydrocortisone and thiamine, may prove to be effective in the reduction of vasopressors dosage and mortality of patients with sepsis and septic shock.

Mental well-being is the state in which person understands his or her aptness and can handle the stress of life, whereas decision making competency (DMC) is something in which an individual can make and take responsibility for fulfillment of commitment to appropriate decision in punctual manner. A simple decision making is combination of individual’s knowledge, experience and how they deal with the various problems in life. Moreover, mental well-being includes cognitive, emotional and behavioral response towards personal life of an individual. The correlation between mental well-being and DMC build resilience in adults. The research setting was D.A.V Institute of Engineering and Technology (DAVIET), Jalandhar, Punjab. Total 100 sample were selected with nonprobability purposive sampling technique to collect the data. A self-structured mental wellbeing scale used to assess the mental well-being among early adults and modified decision making questionnaire scale used to assess the DMC among early adults. The study concluded that mental well-being and DMC are directly prepositional to each other. Hence high mental well-being causes high DMC or vice-versa.

Introduction: The purpose of the study was to explore the experiences of Nepalese nurses on caring for hospitalized stroke in the acute stage. Material and Methods: A qualitative study was conducted among a purposefully selected sample of 16 registered nurses aged 24-55 years who were working in the neurology ward in a Teaching Hospital, Nepal. Focus group discussion using interview guidelines was used for data collection where the qualitative content analysis was used for data analysis. Results: The experiences of nurses regarding the deep understanding of caring for hospitalized stroke patients in the acute stage were characterized by three major themes: Perceived caring practice for the stroke patients, perceived barriers of caring practice for stroke patients, and ways to promote caring practice for stroke patients. Conclusion: The study suggests that there is a huge demand for a holistic approach to care for addressing the holistic needs of a person with a stroke. However, it was influenced by nurses caring behaviours and attitude, patient's health conditions, and their awareness of the disease as well as the organizational culture in the acute care setting. The provision of training about cultural-specific care through yoga integration in nursing might be the way to improve the caring practice of nurses for persons with stroke in the study setting.

Introduction: Catheter-related bloodstream infection (CRBSI) is a critical problem in dialysis center.
Aim: To study the prevalence of central venous catheter related blood stream infections and to identify the microbiological profile of organisms causing CRBSI.
Materials and Methods: This prospective observational study carried out at Dialysis unit over a period of two years on 145 hemodialysis patients, who had cultures of catheter and blood samples were studied.

Malignancy or carcinoma is the unrestrained development of cells. There are numerous kinds of malignancies. In this, we are concentrating on one of the normal tumor of females is malignant growth of the cervix. Cervical cancer is the second most kind of malignant growth found in females, apart from the breast cancer which is first existence. There are abundant quantities of screening tests for Cervical cancer in which Pap smear has done. Pap smear is a virtuous device for first screening of this cancer yet it has constraints as there are consistently odds of blunder due to human perceptions. The main aim of this research is to preclude failures by utilizing computerized methods for identifying the cervical cell. Here, the image of Pap smear has been improved by utilizing Kaun Filter. The weight factor in kaun filter is resolved using an optimization technique called Bayesian Optimization Algorithm. Thus it tends to be an upgraded KF. The reformed picture has been segmented by Active Contour model. In this, the weight upgrade issue has been rectified using Analytic Hierarchy Process optimization technique. Hereafter, the solid features are eliminated from the segmented region which is most significant for identifying the cancer by utilizing ELMCSA (Extreme Learning machine with Crow Search optimization) classifier. Experimental results for the cervical cancer identification by the proposed ELM-CSA outperforms 93.5% of accuracy, 88.7% of specificity,79.21% of precision,92.25% of recall and 79.26% of F-measure than the existing classifiers such as ELM, ENN-TLBO, SVM and RBFN

Plant parasitic nematodes are one of the major crop problems affecting various crop productions worldwide and pineapple is one of the most economically important crops  n the Philippines which is also infected by these plant pathogens. Thus, this paper aimed to identify the species of plant parasitic nematodes associated with pineapple. In this study, the nematodes from soil and roots sample were extracted using Baermann tray method and were identified under the light microscope based on their morphological characteristics. Four species of plant parasitic nematodes were identified namely, Rotylenchus spp., Ditylenchus spp., Helicotylenchus spp., and Rotylenchulus spp. Wherein, Helicotylenchus spp. was the most frequently occurring species in the soil with a total of 75.8% whilst only 1% in the roots. The occurrence of these plant parasitic nematodes indicated that the soil environment in the area was favorable for these organisms.

Periodontitis is a chronic inflammatory disease that affects the supporting structures of teeth, resulting in tooth loss. The aim of the study is to evaluate and compare the effect of scaling and root planing alone and combination of scaling and root planing (SRP) with low level Gallium Aluminium Arsenide (GaAlAs) laser therapy in patients with moderate chronic periodontitis

In this paper, emotion recognition using EEG signals has been reviewed. The methods applied, dataset used for simulation, the results obtained along with the limitations and future work/gap is summarised in this review paper. This paves a way for the upcoming researchers to focus on the problems to be solved and the methods to be proposed as a novel new method or could be an integration or hybrid of the existing techniques or algorithms, along with the dataset to be used

Need assessment is one of the important steps that should be conducted to be able to provide health care to patients with advance stage cancer because by understanding the needs of the patient, an appropriate and proper care can be provided. Inadequate efforts to\meet the needs of patients will affect their quality of life and their satisfaction towards health care. This descriptive study uses Needs Assessment for Advanced Cancer patients (NA-ACP) questionnaire to describe the patient needs based on seven main need domains of advanced cancer patients as well as several additional needs. The results of this study show that the three most needed domains (100%) by advanced cancer patients are medical  information and communication, psychological/emotional support and other needs. Meanwhile, the most frequently felt need, i.e. from moderate to high, (98%) is other needs. Based on those results, it is recommended that hospitals and health care workers should pay more attention to the advanced cancer patients, especially the need for medical information and communication, psychological/emotional needs, financial need, and other needs. To address the issue, training on communication can be provided to health care workers, health education can be given to patients through picture/video media, palliative care counseling unit and cancer support group can also be established. In addition, a clear information media on how to access financial support available for the patients should also be provided.

In general computing theory, Array is one of the data structures to hold a group of same data type elements.  Static array holds the underlying elements in an initial allocated memory space.  In contrast, dynamic array grows the memory allocation automatically and dynamically based on the insertion request volume.  Our research work is to leverage dynamic memory overlay array mechanism in Enterprise Data Hub.  It is continuation of our earlier work on Hybrid LRU Algorithm, which depicts about the experimental advantage of execution time optimization and efficient page/cache hit ratio, using hybrid Least Recently Used algorithm with priority mechanism.  With the ability to change the allocated space dynamically using memory overlay concept, Dynamic array improves the storage scalability and faster execution.

Information from ethnic groups or indigenous traditional medicine hasplayed a vital role in the discovery of novel products from plants as chemotherapeuticagents. Wound healing is a complex and complicated process. It runs through a number of phases, which either run concurrently or are intimately interlinked through some chemical, biochemical and cellular pathways.Juglans regia is a medicinal plant which is widely used for the treatment of many ailments.The array of human health benefits derived from this plant is due to the abundant presence of the different phytochemical compounds present in it. Plant material (leaves) of Juglans regia of family Juglandaceae was collected from Saloora Ganderbal, Kashmir. The preliminary phytochemical screening of the plant material was performed which showed the presence of many phytochemical compounds in it. The extracts were formulated 1% w/v in gum acacia dissolved in normal saline. JR (Juglans regia) 1% w/v was used as dose. A full thickness of the excision wound (400mm²appx.) was created along the markings using toothed forceps, a surgical blade and pointed scissors.It was observed that wound contractingability of animals treated with ointment containing 1% (w/w)methanolic extracts of Juglans regia were found to be significantly higher (P < 0.001)on days 8th, 12th and 16th as compared to the control group.

Childbirth experience is one of the important outcomes of childbirth, so creating a positive experience of childbirth should always be considered as one of the goals of health care providers and programs. Present study investigate the Iranian women’s experience of physiological childbirth and its related factors. This cross-sectional study from June until Dec 2019 was conducted on 185 women based on estimating the average population formula, who had the experience of physiological childbirth in Fatemieh hospital in Hamadan, Iran. Samples were selected by convenience method. Data collection tools included demographic and midwifery questionnaire, childbirth experience questionnaire (CEQ) and midwifery care observation checklist. Data analysis was done using SPSS software (version 24) and descriptive and analytical tests such as Kolmogorov-Smirnov for assessment of normal data distribution and multiple linear regression test were applied. Significance level in the tests was considered less than 0.05.The overall mean score of childbirth experience was 71.85 ± 10.77 (score range of 22-88). Maternal satisfaction with the midwifery care, and the behavior of care providers were reported to be 67.13% and 75%, respectively. In 172 (92.97%) of cases, the backup midwife was present at the mother's bedside. On the other hand, the mean score of childbirth experience in the areas of “support of obstetric care providers”, especially back-up midwives (3.44 ± 0.53), and “own capacity” (3.12 ± 0.53) were higher and lower than other areas, orderly. As satisfaction with physiological childbirth was high, suggesting this type of midwifery care conveys great sense of security and satisfaction. This indicates that, the constant presence of midwifery staffs when women need them and minimal use of medical interventions, play an effective role in creating a positive experience of childbirth.

Background: Spastic diplegic children suffer from spasticity, muscle tightness and limitation of range of motion impeding their functional abilities and gait. purpose: To evaluate the immediate effect of low frequency whole-body vibration on spasticity, popliteal angle, and gait kinematics in spastic diplegic children. Methods: Study was carried out on forty spastic diplegic children their age ranged from 4 to 6 years old they were selected from the outpatient clinic of the Faculty of Physical Therapy Cairo University, they had level 1 and II according to the gross motor function classification system and had grade of 1 and 1+ spasticity according to modified Ashwarth scale, Hoffman reflex (H/M) was used to assess spasticity,2- in-1 Digital Angle Ruler used to assess the popliteal angle range and Tekscan Software was utilized to evaluate gait kinematics. Results: there is significant decreases in spasticity and popliteal angle immediately after application of whole-body vibration associated with significant improvement of kinematics gait parameters (P< 0.001). Conclusion: Low frequency whole body vibration is an effective modality for spastic cerebral palsied children it reduced spasticity and improves range of motion and kinematic gait parameters.

BACKGROUND OF THE STUDY: Alcohol is the number one toxic substance consumed by people of all age groups, which makes its use a public health problem. The overall trend shows that university students are those who suffer the most pressure. Aims-The aim was to find out perception of alcohol intake regarding global positive transformation among medical students. Objective - assess the perception of alcohol intake regarding global positive transformation among medical students. To explore the alcohol related habits among medical students. Materials and Method-A work site cross-sectional descriptive study was conducted amongst 300 medical students at selected medical colleges of Pune City.Data was collected by screening questionnaire related to alcoholIntake. Result:In this study demographical data showed that majority of the student 152(50.6) from the age group of 18-21 years. Majority of students 208(69.33) are male.Related to the screening questionnaire of alcohol Intake among medical Students data showed majority of the students 185(61.66%) students’ parents does not drink alcohol, 185(61.66%) students doesn’t drink alcohol, 253(84.33%) students friend’s drink alcohol, 185(61.66%) of students not applicable for 1st Drink, for the circumstances of drunk alcohol or May drunk alcohol 115(38.33%) of students said for Enjoy Partying, For the spending on alcohol per month in that 185(61.66%) Not applicable, 185(61.66%) are not applicable for control their interest on drinking alcohol and 185(61.66%) says never drink alcohol.In that majority 52.86% medical students are showing Alcohol is a powerful agent that makes global positive transformation. Mean responses are 158.6 for true and 141.4% are for false responses. Which interpret that alcohol drinking make you positive at global transformation.
Conclusion: The present study conclude that medical students are showing Alcohol is a powerful agent that makes global positive transformation.

This paper states that police personnel 'views on the causes of job stress such as content structure (objectives and objectives), structure (size, level of centralization), structural processes (leadership, decision-making, etc.), type of work (shifts, etc.) environment (employee safety). , rewards etc.) Symbolize the magnitude of the climate. This research can be descriptive and reveal existing facts. The report is about police officers anywhere in the Tuticorin region, south of Tamilnadu. The study focused on 52 police stations divided into eight sections and 600 samples collected in three completely different categories of police officers. Police pressure collection (PSI) is usually live on the amount of job stress. An acceptable mathematical tool was used for data analysis. As a result, most police officers work very closely together. Female police officers face higher pressure compared to male police officers. This study concludes most constables are under moderate stress level and the results show significant differences between the state of job creation (objectives and objectives), composition (size, level of centralization), structural processes (leadership leadership, determination etc.), staff nature (shifts, etc.) and the environment (employee safety, salaries, etc.)

Schizophrenia is a chronic disease that requires long-term medical treatment and causes physical, psychological, and social problems related to the disease and the potential side effects of its treatment. One of the nursing therapies that support the family is supportive therapy. Supportive therapy is a therapy that is given to exchange experiences regarding the problems experienced to improve family coping. The purpose of this study was to determine the effectiveness of therapy supportive on the ability of families to care for family members who are people with mental disorders at Purbaratu Health Center, Tasikmalaya City. The type of research is analytic research with approach quasi-experimental to the type of experimentaltest and post-test one-group design, with a sample of 22 families were divided into 2 groups. The implementation of supportive therapy for each group was conducted 2 times at the Purbaratu Health Center. The ability of the family referred to in this therapy is the ability to recognize mental disorders and their treatment, the ability to empower other family members in care, and the ability to involve the external family in treating people with mental disorders. Based on results the Wilcoxon test obtained a significance value of 0.0001 (r<0.05). So the conclusion is that there is a significant difference in the score of family ability in caring for family members of people with mental disorders between before and after supportive therapy.

Many Indonesian families have limited access to a high quality of health care services and still practiced unhealthy behaviors. Therefore, the healthy Indonesia program with a family approach aims to increase the accessibility of people to health services by home visits. The study aimed to analyze the healthy family index and to identify the 12 healthy family indicators coverage in Nulle Village East Nusa Tenggara Provinces. It will become tools for health facilities to create intervention based on the indicators which are not implemented by families. A household survey method was used to collect the data from 777 families in Nulle Village. Data was collected by using Indonesia's healthy family Questionnaire. The Healthy family index then was then determined according to three categories namely; healthy family (>0,80); pre-healthy family (0,50-0,80), and unhealthy family (<0,50). The study indicated that 56,49% of families were categorized as pre healthy families, 28,05% were healthy families and unhealthy families accounted for 15,44%. The lowest healthy indicators coverage were hypertension patients who take regular medicine (19,84%), followed by severe mental disorder patients who got access to medication (20%), and only 30,58% couple of childbearing age participated in the family planning program. The majority of the family are categorized as pre healthy families, therefore it is highly recommended that Public health Nurses should be more active to promote the 12 healthy family indicators. The family should be well informed so that they can improve the family’s health quality.

Introduction:Neonatal sepsis is an important cause of morbidity and mortality in developing countries.According to the World Health Organization(WHO),around5 million newbornsdie yearly, 98% of deaths occurring in developing countries
Objectives: To identify prevalence of neonatal sepsis,aetiological profile,antibiotic sensitivity pattern and outcome in a tertiary care centre and to formulate a consensus recommendation for empirical antibiotic usage for neonatal sepsis in our hospital.
Method:A hospital based prospective observational study was done from March 2019 to August 2020 on babies diagnosed or suspected as cases of neonatal sepsis in our hospital.
Results:Atotal of 200 neonates were included in our study with clinical suspicion of sepsis during the study period. 127 (63.5%) neonates were identified as EOS (0-3 days) and 73 (36.5%) aslate onset sepsis (4-28 days).Prematurity was thecommonest predisposing factor(68.5%).Feeding intolerance was the commonest presentation (74%).Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of C-reactive protein (CRP) + absolute neutrophil count (ANC) were 93.8% ,90.8%, 34.9%, 99.6% and 90.9% respectively.(p <0.001).Klebsiella pneumonia + Klebsiellaoxytoca(16+1) was the most common isolate (35.4%),There were 6 (12.5%) isolates of Staphylococcus aureus out of which 2 were methicilin resistant aureus(MRSA).
Conclusions:Of the 200 neonates with suspected neonal sepsis,63.5% had EOS. Prematurity was the commonest predisposing factor(68.5%) and feeding intolerance was the commonest presentation (74%).Klebsiella (35.4%) was the most common isolate.

Background: Cow's Milk protein Allergy (CMA) is a serious and potentially lifethreatening problem for an estimated
2.5 % of children. Infants with CMA are at risk of growth faltering, however, data are still
limited. .
Objectives: The aim of the study was to assess growth and nutritional status in infants with CMA and to evaluate the implications of CMA in infants with flatteringgrowth.
Methods: This cross sectional study was performed in the period from April 2019 to September 2019 in Pediatrics Department of Zagazig University Hospitals. The study included 72 patients with CMA diagnosed by oral challenge test after elimination diet. Allergy work up included skin prick test and measuring specific (Immunoglobulin E)
IgEforCow'sMilkprotein(CMP)forallpatients.Thegrowthandnutritionalstatusofthepatients  World Health Organization (WHO) growth charts and growth zscores for weight-for-age, weight-for-height and height-for-age, in addition to
laboratoryinvestigations.
Results: Data from 72 infants (43 male and 29 female) with age of 9.92 ± 5.853 months indicated that 9 out of 72
infants(12.5%)werediagnosedasImmediateIgEmediatedCMAwhiletheother63infants(87.5 %)wereconsidered delayed non-IgE mediated CMA. Twenty-five infant out of 72 (34.7%) suffered from faltering of growth. We found that 20.8% of infants had z score < -2SD as regard weight for age while (9.7%) and (4.3%) had z score < -2 SD as regard height for age and weight for height respectively. We also, found that 36.1% of infants suffered from iron deficiency anaemia with haemoglobin (11.16 ± 1.53) g/dl, while 29.2% of infants showed hypoalbuminemia with serum albumin level (2.9 ±0.177)g/dl.
 

At present, the oil and fat industry of Uzbekistan is one of the leading enterprises in the food industry, mainly processing cotton seeds. Further introduction of new equipment and progressive technology, mechanization and automation of production processes, modernization of existing equipment was carried out, enterprises specialized in processing two main types of raw materials: cotton seeds and sunflower seeds. Uzbekistan began processing other types of local raw materials (soybean seeds, safflower seeds, etc.). The expansion of sowings of high-oleaginous varieties of sunflower, soybean, safflower continued and the oil content of seeds increased. For 3 years of the current five-year plan, the oil content of seeds increased by 2% against 4.2% over the period of the previous five-year plan.

This article examines the nosogeographic conditions of Bukhara region and the peculiarities and problems of public health. Bukhara region is located in the south-west of Uzbekistan, in the lower reaches of the Zarafshan River, and the main part of its territory consists of deserts. The influence of the desert plays a leading role in the nature of the region. Although there are differences in the nature of oases compared to desert areas, they have all the features of desert conditions. Extreme aridity and heat, as well as a lack of precipitation, have a direct impact on the health of the population. The unsuitability of drinking water content and high salinity of soils are also likely to cause various diseases. Representatives of flora and fauna, which are widespread in the region, have also adapted to these natural conditions. They can be conditionally divided into desert and oasis types. Some of the most common medicinal plants in the region can be used in medicine to make a variety of medicines. Due to the natural conditions of the region, there is an opportunity to build health facilities in the region for the treatment of certain diseases, including kidney, musculoskeletal and other diseases.

Today, one of the main conditions for ensuring the competitiveness of a higher educational institution is the level of professional competence of a university teacher, which determines the quality of training of future specialists. In the light of the modern reform of the education system, the introduction of information and communication technologies for competent teachers is taking place in higher education. Under these conditions, the problem of the formation of information competence of a student becomes a determining factor in future professional activity, in connection with this there is a need to determine information competence as an important component of the general professional competence of a modern specialist. Future chemistry teachers should have a system of knowledge and skills that make it possible to correctly use information technologies in professional activities, know the possibilities and options for using information technologies in chemistry classes, and determine their pedagogical expediency in the study of certain chemical processes and phenomena.

In this paper deals with an production inventory model without shortages in a fuzzy environment with fuzzy constraints for crisp production quantity or for fuzzy production quantity are rooted in fuzzy inventory management . We have applied graded mean method for defuzzifying the fuzzy general production inventory cost in trapezoidal fuzzy numbers. The aim of our work is to find optimal solution of these models by using Lagrangean method and Kuhn-tucker method finally a numerical example explained to show the uniqueness obtained in both crisp and fuzzy inventory model.

In this article, some indicators of the hemogram in premature newborns are studied. The analysis and comparison of the obtained indicators in children with hemorrhagic and ischemic lesions of the central nervous system was carried out. Small distinctive features were revealed in intraventricular hemorrhage and cerebral ischemia

Cyber-Physical Systems (CPS) is a modern generation of intelligent systems with the integrated computational performance and physical capacities. The CPS is affected by the malicious attacks due to the growth of system complexity and system openness. Therefore, an efficient data transmission method is developed to improve the CPS performances. In this paper, the Orthogonal Frequency-Division Multiplexing (OFDM) based transmission device is used in the CPS to achieve the high data rate requirement of modern communications. The Priority Aware Frequency Domain Polling (PAFDP) protocol is proposed to detect the desired node from the group of nodes based on the priority value. Here, the priority is identified by using the throughput and data rate. Moreover, the malicious nodes existing in the network are identified and avoided to minimize the packet loss in the network. The performances of the PAFDP-OFDM-CPS are analysed in terms of packet delivery rate, packet loss ratio, throughput and overhead. The PAFDP-OFDM-CPS method is evaluated by using three existing methods such as Trust Aware Wireless Routing Protocol (TAWP), Trust Aware Routing Framework (TARF) and Adaptive Duty Cycle Control Based Opportunistic Routing (ADCCOR) protocol. It was found that the PDR of the PAFDP-OFDM-CPS is 99.4% for 5
malicious nodes high compared to the TAWP and TARF protocol.

Background/Objectives: Coronavirus disease (COVID-19) is an emerging viral respiratory disease
that has currently reached apandemic status.This study aimed to assessCOVID-19 knowledge,
attitudes, and practices among the Kurdishpopulation in Iraq.
Methods: This cross-sectional studywas conducted fromJuly 15 to September 15, 2020 among the
Kurdish population in Iraq. A total of 885 subjects were interviewed. All subjects were aged 15–75
years. Knowledgescores, attitudes, and practices of subjects were analyzed according to demographic
characteristics.
Results:The study subjects were largely male,the average age was31.79 years,and 41.92% subjects
were from Erbil province. Approximately 85.31% subjectshad enhancedknowledge regarding disease
prevention and control. The lowest subscale scores were related toclinical manifestations of the
disease. Knowledge scores were significantly associated with age, place of current residence, and
level of education.A large number of participants believed COVID-19 would be controlled and the
fight against the pandemic would be won.Subjects’ attitudes toward success differedsignificantly by
demographic characteristics, except marital status. Approximately 40.03% subjects reported that they
had not visited a crowded place, and 60.22% of these subjects wore face masks when leaving home.

This article talks about changes in the format of the Russian-language media in Uzbekistan. During the years of independence, the attitude towards the media has changed radically. From the very beginning, measures were taken to create their legal foundations, in the past years, especially over the past 10 years, large-scale measures were taken to liberalize the media and ensure freedom of thought. First of all, I would like to note the creation of a legislative base that meets international standards and ensures the development of the media

The aim of our study was to study the features of impaired left ventricular diastolic function in patients with chronic heart failure, depending on the clinical course of the disease. A total of 131 patients with CHF of ischemic origin with I, II and III FC CHF (men aged 38-60 years, mean age 54.51 ± 6.89 years) were examined. Patients with FC I were 31 (23.7%) patients, with FC II - 51 (38.9%) and FC III - 49 (37.4%) patients. The structural
and functional state of the myocardium and the process of LV remodeling were assessed by echocardiography with Doppler ultrasonography. EchoCG was performed on the device "MEDISON ACCUVIX V20" (South Korea), using a 3.25 MHz transducer in standard echocardiographic positions, transthoracic method in accordance with the recommendations of the American Society of Echocardiography (ASE). In patients with CHF, diastolic function disorders were identified in 74.8% of cases: grade I (impaired relaxation) was recorded in 38.9% (51 patients), grade II - (pseudonormal) in 21.4% (28), type III (reversible restrictive) - in 14.5% (19) patients. An analysis of the grades of diastolic dysfunction showed the predominance of relaxation disorders in 52% of patients and an increase in the number of patients with restrictive type of diastolic dysfunction with an increase in CHF FC. Thus, in 74.8% of CHF patients, impaired LV diastolic function was observed, characterized by its deterioration with the progression of the disease. At the same time, impaired LV diastolic function was characterized to a greater extent by impaired relaxation, and with the progression of the disease, a restrictive type of LVDD impairment.

Neoangiogenesis plays a crucial role in tumor development. The method that is most commonly recommended for assessing this process is determining the so-called microvessel density (MVD) in the tissue sample. In relation to tumors of the central nervous system, it seems that VEGF-A along with its receptor VEGFR-2 are the most significant factors, and the important role of both of them is connected with their increased expression in tumor tissue. The study concerned 48 adult patients of both genders, treated surgically for newly diagnosed solid brain tumors andconsisted of histological assessment of the material gained from the surgically removed brain tumor. The highest level of VEGF in tumor tissue was observed in gliomas – mostly HGG - 12.61 (N = 23, p = 0.000059). As for VEGFR-2 in tumor tissue, the highest average level was characteristic for metastatic tumors - 13.67 (N = 6, p = 0.037) and it was slightly lower in HGG - 12.2 (N = 23, p = 0.037). The average MVD in tumor tissue was the highest in HGG - 20.13 (N = 23, p = 0.047) and other tumors - 18.33 (N = 3, p = 0.047). The remaining types of tumors in the studied group had similar microvessel density – from 13.67 to 14.71.

In Panchakarma, Nasya plays an important role in treating various diseases affecting Urdhwajatru (the part of the body above the shoulders) and the Central Nervous System. Human beings are considered to be in the form of Urdhvamulam Adhaha-shaka where proper irrigation of the Moola (root) will sustain the Sakhas (branches) in a healthy manner. There are different types of Nasya being described in this context.  Nasapana is one such related procedure in which the medicines are introduced through the nasal pathway. Not many references are available in classics as well as contemporary literature regarding the same. In the absence of such references, following a Standard Operating Procedure (SOP) is required to demonstrate and replicate its safety cum efficacy. An observational study was done on 50 patients suffering from various diseases treated with a SOP developed on Nasapana. The dose, methods, sign and symptoms of Nasapana, complications and suitability of the same were studied in detail. Data related to patient, disease condition etc. were collected and observed for the safe execution of the procedure. Not a single case of complication was noted, but, in all patients the severity of disease got significantly reduced. It can be concluded that this SOP may be followed for doing Nasapana procedure.
 

Numerous scales have been developed and used for measuring social interaction anxiety among students and educational professionals. Social Interaction Anxiety Scale (SIAS) is one such important measure that has been widely used around the world. However, little is known about its testing in Pakistani context. The present study examined the psychometric features and theoretical structure of the SIAS in Pakistani higher education context. Data were collected from 291 students from three public sector universities of Khyber Pakhtunkwa. The validation was conducted in two phases. In the first phase, Exploratory Factor Analysis (EFA) was performed to identify the factor structure and the underlying dimensions in the scale. Based on the Principal Component Analysis (PCA) a four factor model emerged consisting of 20 items. In the second phase, Confirmatory Factor Analysis (CFA) was performed to evaluate the four-factor hypothetical model based on Structural Equation Modeling. The results showed that SIAS is a valid and reliablescale. The findings of the present study supported the multidimensionality of the scale. The model indicated an excellent model fit for the 20 items scale that can be used for measuring social interaction anxiety among students in higher education. The limitations of the study along with conclusion and recommendations are provided for future research.

Background: Vascular Endothelial Growth Factor –A (VEGF-A) has a vital role in angiogenesis inhematological malignancies including acute lymphoblastic leukemia (ALL).Many singlenucleotide polymorphisms(SNPs) in VEGF gene may affect susceptibility of ALL in children.
Aim of the study:  To investigate the frequency of -460 VEGF gene SNP and their impact on plasma level of VEGF-Ain children with ALL.
Material and method: This study included 40 children with ALL and 40 healthy children as controlcarriedout at the Oncology Unit in Basrah Children specialty Hospital from Oct 2019 to March 2020. VEGF-A plasma level evaluated using ELISA assay, PCRteqnique was used to detect the -460 VEGF SNP.
Result:VEGF-Aplasma level in ALLchildren was higherthan control, there is significant difference of -460 VEGFSNP between ALLchildren and healthy control and the impact of gene polymorphism on plasma level of VEGF-A in ALL children was highly significant.
Conclusion: VEGF-A level and gene SNPcould play a central role in ALL pathogenesisand progression.

Corn oil is readily available and inexpensive can be used to fabricate different types of polymers. In the present study, epoxidised corn oil has been prepared by corn oil is treated with acetic acid and hydrogen peroxide. The epoxidation is confirmed by FT-IR, iodine value and oxirane oxygen analysis. Natural fibres such as coir, banana, jute, sisal etc are locally available in abundance and can be used to fabricate the composite materials for different applications. Epoxy composites are prepared from natural fibres with different weight ratios using tryethylamine as hardner and phthalic anhydride as curing agent. The soil burial degradation and solvent absorptivity percentage are observed. Soil burial degradation study of polyesters and their composites are confirmed by SEM analysis.

This paper deals with analysis of the eponymous character of Carrie, one of the best characters crafted by Stephen King. Despite the success of the novel, Carrie received and still received negative remarks for the portrayal of the lead in a misogynistic manner and usage of genderbiased language. Whereas King magnifies only the position of a young girl; the deft handling of supernatural elements (telekinesis) in Carrie gives wings to her liberation thus keeping an end to her powerlessness despite possessing such an unearthly enormous power

Congenital heart disease (CHD) is one of the most common congenital defects, present at birth, it can affect the walls, valves or the great vessels of the heart. CHD considered to be among the most common malformations in newborn infants with an incidence of 8 out of 1000 live births worldwide. Children with congenital disease certainly need special health care. Healthy teeth and gums are important for everyone, especially for children with heart conditions. Providing children with dental care during the COVID-19 pandemic, and in particular during the increased social restrictions, can be a challenging task. The purpose of writing this systematic review is to examine about oral health condition and dental care in children with congenital heart disease during the COVID-19 pandemic. Data source of Pubmed, published from 2011-2021. After eliminating duplicated articles, the titles and abstracts of each article were analyzed across 119 articles resulting in 86 articles being excluded. The full-text articles in the remaining 33 articles were re-analyzed and excluded 23 articles and produced 10 articles which were then entered into the analysis. Based on this systematic review shows that children with congenital heart disease (CHD) have poor oral health. Education and disease awareness about and prevention of dental illnesses have to be guided and steered by the parents. The role of dentists and pediatricians is very important in this case. Providing children with dental care during the COVID-19 pandemic, and in particular during the increased social restrictions, can be a challenging task.

Deciduous teeth have an important role in the process of growth and development of a child, requiring guidance and mentoring from parents as first educators in early childhood. This study aims to analyze the determinants of parental behavior in maintaining deciduous teeth in early childhood. Method: This was an analytic study with a cross sectional design. The study was conducted on parents of students in PAUD Gandul Sub-Distric, Cinere District, Depok City, with a total sample of 90 respondents. Collecting data using a questionnaire that has been tested for validity with product moment correlation and reliability with Cronbach Alpha Coefficient. Data analysis using Chi-Square and Logistic Regression. Results: The determinant variables that had a significant relationship with parental behavior were attitudes towards dental health with p value 0.000, access to information p value 0.033 and teacher influence p value 0.037. The variable that has the greatest influence on parental behavior is attitudes towards dental health with an OR value of 5.636. Conclusion: Parents' attitudes have the greatest influence on behavior to maintain deciduous teeth in early childhood.

This study aims to determine the risk reduction of the impact of an earthquake disaster based on local wisdom on the island of Lombok, West Nusa Tenggara, and to know the inheritance system of local wisdom in reducing the risk of earthquake impacts. The results show that the reduction of the risk of earthquake disasters has several traditions used by the inhabitants of Lombok Island, which still use the old traditions when their ancestors nenk,
such as the community has long interpreted natural phenomena symbolically as positive and negative markers in the form of myths, beliefs, fairy tales and in the past. immortalize it in ancient manuscripts, poems, kidung, which eventually becomes local wisdom capable of building a culture of disaster awareness. And the inheritance system of local local wisdom for disaster risk reduction in the midst of global cultural domination of local culture is implemented through a strategy of increasing the role of the family as the spearhead of planting and fostering positive values of local wisdom to the younger generation, increasing the role of culture-based disaster education and local wisdom in institutions. - formal educational institutions, utilizing the implementation of ritual ceremonies related to disasters in the form of events so as to attract public appeal, developing the concept of functional value of multi-functional and earthquake-resistant building infrastructure.

The aim of the present case report was to present a novel technique for treatment of skeletal class II malocclusion using implant supported class II elastics. MBT 0.022 fixed mechanotherapy was employed along with a total of four power headed implants which were placed between lower 1st and 2nd molars and upper central and laterals to attach class II elastics. After seven months of implant supported mandibular advancement Class I molar relations were achieved and overjet was eliminated with a reduction in profile convexity. Based on our literature search no such technique has been reported.

This study aims to determine the spiritual well-being of students at Asia-Pacific International University. The sample in this study amounted to 52 samples obtained during a period of 1 month. The data analysis technique used in this research is the factor analysis technique, which is processed using SPSS 16. The results showed that the following arefactors regarding spiritual health of students at university, they are in terms of developing worship of the Creator, developing oneness with God, developing peace with God, developing joy in life, developing prayer life, developing infer peace, developing respect for others and developing kindness towards other people.

Background: Patients on a ventilator often experience pain. Pain experienced by patients can be minimized by proper assessment of pain. The appropriate wound assessment instrument for ventilated patients is the Critical Care Pain Observational Tool (CPOT). CPOT is one of the coding instruments for adult patients that is mounted
on a ventilator and is used for patients who cannot report complaints verbally. The purpose of this study was to describe the assessment of pain using CPOT in ventilator mounted patients. Materials & Methods: The design used a literature review with 10 article participants using the Pubmed, Proquest, Google Scholar search system. Journal analysis Literature Review on 10 journals was carried out using PICO analysis. Results: The results obtained CPOT instrument has a high enough value. CPOT measurement results have a good level of conformity from BPS measurement results. CPOT is a measuring tool that is more relevant, valid, and responsive than the Wong-Baker scale to assess comfort in ventilated patients. Conclusion: CPOT is easier to use because it has clear operational resolutions on each item of observation.

Background: Ankle arthrodesis is major surgery need good experience. Decision of ankle fusion should be taken after exhaustion of the all other treatments methods. We aimed to evaluate the function and radiological outcome of patients with ankle arthrodesis who are operated upon in Zagazig university hospitals for post-traumatic ankle arthritis. Patients and methods: 18 patients ranging from 26 to 60 years suffering from posttraumatic ankle arthritis were included and underwent Trans fibular Ankle Arthrodesis with Rigid Internal Fixation. Patients followed up post- operatively in outpatient clinic according to their planned visits for assessment of functional and radiological outcomes. Assessment of functional outcomes and pain was done through American Orthopedic Foot and Ankle Society (AOFAS) scale. Results: The mean Preoperative AOFAS score was 46.89 (±3.69 SD) with range (40-52) while the mean Postoperative AOFAS was 74.44 (±10.20 SD) with range (56-90).There were 5 (27.8%) with moderate pain and 13 (72.2%) with severe pain while post-operatively there were 5 (27.8%) with no pain, 10 (55.6%) with mild pain, 1 (5.6%) with moderate pain and 2 (11.1%) with severe pain. There were 15 (83.3%) with average healing time (12 weeks) and 3 (16.7%) were delayed (12-24 weeks). According to complications, there was 1 (5.6%) case with Wound sepsis, 1 (5.6%) with Post-operative deformity and 2 (11.1%) were Non-union. Conclusion: Ankle arthrodesis is gold standard operation for late stage painful ankle arthritis in well planned and selected patients.Trans fibular ankle arthrodesis achieves a high rate of union and good functional outcome on follow up.

Background: The most common deformity of the knee in children is infantile genovarum. We aimed to evaluate the outcome of children with genu varum after proximal tibial dome shaped osteotomy. Patients and methods: a prospective case study was conducted on 12 patients with Persistent physiological infantile genu varum and underwent Dome-Shaped Proximal Tibial Osteotomy. During follow up period, the angle formed by the femoral condyle and the tibial shaft determined by a line drawn parallel to the inferior surface of the femoral condyle intersecting the anatomical axis of the tibia (femoral condyle-tibial shaft angle), normally about 90°, used for assessment of correction in plain X ray to the knee and tibia to avoid need for full length radiograph. All cases were evaluated pre and post-operatively according to Modified Hospital for Special Surgery Knee Scoring System Results: 10 (83.3%) knees had full correction of deformity while 1 knee (8.3%) had under correction and 1 knee (8.3%) showed over-correction of deformity. The mean pre-operative HSSKS scores were 70.16±11.3 while the mean post-operative HSSKS scores were 91.4±2.1. The subjects HSSKS results were improved from pre to post-operatively with a statistically significant difference between them. Conclusion: Dome-Shaped Proximal Tibial Osteotomy is associated with good outcome and the reasonable stability arising from the anteroposterior orientation of the osteotomy and greater surface area for early union, and early weight bearing and active knee exercise indicate a good safety profile and it should be recommended to correct Infantile Genu Varum

The study explains in depth how the Iraqi Ministry of Higher Education rescues and successfully completes the academic year 2019-2020 in very difficult and complicated circumstances. 101 Iraqi higher education institutions, with nearly 50,000 academics and more than 811,000 students.All started running, teaching, and learning unexpectedly. In less than a week, the ministry and its executives and special ministerial ICT workers will never stop returning life to the ministry of higher education institutions and raising the address of our universities, and we will return our universities and learning institutions to operate from our homes and have never stopped learning.Universities may not have true and strong infrastructure in Iraq, but we work and fully invest in what we have. After meeting the criteria for academic year expectations and reviewing what has been accomplished, a decision was made to complete it via e-exams of student accomplishments. The condition of the health society led the ministry to this decision because it was difficult to return the universities to its ordinary works to do the exams. Unique e-exams have been conceived and will begin to be carried out with postgraduate students from 14
June 2020, following the training of all 101 institutional review committees on e-exams and their procedures and mechanisms. The results obtained show us very clearly that the Ministry of Higher Education is saving the 2019-2020 academic year with a high degree of standards.For the next year 2020-2021, the ministry agreed to benefit from what has been accomplished and prepared a roadmap to improve learning productivity to implement blended learning with micro face-to-face learning. With the introduction of e-learning and lifelong learning, Iraqi society has taken a very large move towards information society.

Acute kidney injury is a common complication of myocardial infarction (MI) and scarce data were available on the effect of vitamin D3 on heart and kidney functions in MI. In this study, we investigated the potential protective effect of vitamin D3 on cardiorenal functions in isoproterenol-induced MI in rats and the possible mechanisms involved. It was shown that in MI rats, there was a significant increase in serum levels of (creatine kinase myoglobin binding, lactate dehydrogenase, creatinine, malondialdehyde, interlukin-6 and tumor necrosis factor alpha) and urine levels of (total protein and albumin), with a significant decrease in urine creatinine level, creatinine clearance and serum levels of [reduced glutathione and 1, 25 dihydroxy vitamin D] in comparison with
the control rats. On treatment of rats with vitamin D3 prior to induction of MI, thesebchanges were significantly improved in comparison with the MI rats. Histopathologicalband immunohistochemical examinations of heart and kidney in MI rats reflected the deterioration in their structures with presence of marked apoptosis which were ameliorated on treatment of rats with vitamin D3 prior to induction of MI. In conclusion, vitamin D has a protective effect on heart and kidney functions in the rat model of myocardial infarction and this beneficial effect could be related to its anti-inflammatory, antioxidant and anti-apoptoticactions.

Global data suggest Dental caries is a dysbiotic, biofilm-mediated disease imparting serious health problems impacting almost half the world population. An ecological equilibrium of microbes is crucial for maintaining the human biofilm in a healthy state. One way to restore this homeostasis is to equilibrate the acidity and alkalinity processes to maintain a neutral pH. Physiological factors that can countervail the acidification of biofilms mainly include the buffering capacity of saliva and the metabolism of salivary substrates, such as urea and arginine, which generates alkali in the form of ammonia. Hence, there has been an increasing interest in therapeutic interventions that modulate the microbiome of biofilms to reinstate this balance. The current scenario focuses on approaches using either antimicrobial strategies or to augment the growth of health-promoting bacteria. Here we review, the knowledge gained from laboratory and clinical studies that support a remarkable role of arginine metabolism in the ecological balance of supragingival biofilms, inhibition of caries, and also report its promising clinical applications in dentistry. The major points are the following: 1. the significance of arginine and its associated mechanism of action. 2. Potential of arginine to promote remineralization and decrease dentinal hypersensitivity. 3. To Provide oral health professionals with recommendations for using arginine in clinical practice

Purpose. To identify prognostic factors for the development of renal dysfunction (RD) and to develop a method for
assessing and predicting RD in patients with chronic heart failure (CHF).
Methods. A total of 101 patients with functional class I-III (FC) CHF (according to the classification of the New
York Heart Association) were examined. Also, the patients were divided, depending on the glomerular filtration
rate, determined by the calculation method according to the CKD-EPI formula (eGFR), into two groups: patients
with eGFR≥90 ml / min (n = 20), with eGFR <90 ml / min (n = 81). All patients were determined: creatinine (Cr),
eGFR according to the CKD-EPI formula, albumin / creatinine (Al / Cr) level (mg / mmol) in morning urine,
specific gravity in morning urine portion (SG); studied renal blood flow according to Doppler sonography at the
level of the common left and right renal arteries. To assess the significance of signs for determining and predicting
RD in CHF, we used a method based on Wald's sequential statistical analysis with the development of differential
diagnostic tables, determination of diagnostic coefficients (DC) and information content (J) of each sign in groups of
patients with CHF, depending on the level eGFR, determination of diagnostic thresholds (amount of DC).
Results. As a result of the developed differential diagnostic tables, the most informative signs were identified that
determine the unfavorable prognosis of RD in patients with CHF: creatinine above 80 μmol / l, eGFR less than 90
ml / min, Al / Cr ratio in morning urine more than 3.4 mg / mmol, urine specific gravity SG less than 1015,
resistance index (RI) at the level of the right and left renal arteries more than 0.7. The sum of DCs of these signs,
depending on the severity of symptoms, determines the risk of developing RD: a very high risk in the range from
+15 to +32, high risk - from +8 to +14, moderate risk - from +7 to +3, favorable course of CHF - from 0 to +2
points.
Conclusion. Signs of an unfavorable prognosis for the development of RD in patients with CHF were determined:
creatinine above 80 μmol / l, eGFR less than 90 ml / min, Al / Cr ratio in morning urine more than 3.4 mg / mmol, urine SG less than 1015, RI at the renal level arteries more than 0.7.

In the present paper, we introduced the four parameters generalized log-logistic distribution using quadrature rank transmutation map to develop a transmuted four parameters common log-logistic distributions. Also the function of reliability for the four generalized log-logistic distributions is obtained. The continuous case of pdf and cdf for four parameters common log-logistic distributions are traditional. We looked at 10 fit men and 10 old men at the base of cortisol levels when the mineralocorticoid receptor mostly regulates the activity of the HPA axis.. In case of ACTH and Cortisol, both values are were significantly higher in older men compared with young men after fludrocortisone. Lastly, we suggest that the implementation part fits with the probability distribution and the outcome is well linked with the medical report.. This paper will be very useful for medical field in future.

Until December 13, 2020, the total Covid-19 cases worldwide is 70,476,836 cases and counted 1,599,922 deaths globally since the start of the pandemic. The best medicine for Covid-19 has not been found yet, so this review intended to reveal potency of Liriodenine to overcome and help care for those affected. Liriodenine (C17H9NO3) along with Quinine and its derivate Chloroquine and hydroxychloroquine are include in the compound of nitrogen-containing group or alkaloid. The main mechanism of its activity of Liriodenine is DNA Topoisomerase I and II inhibitors that have cytotoxic effect on several human cell lines such as A549, NCI-H226, SPC-A-1, NPC-TW01, ECV2 and 7111, KB, HEp‑ 2, and against gram (+) and (-) bacteria. Review results showed that Topoisomerase Inhibitor posses dual activity that works on both DNA and RNA, so does Liriodenine predict may affect to RNA virus include SARS-CoV-2 strain or 2019-nCoV. The potency of Liriodenine as new agents for Covid-19 diseases is supported by its other activity antifungal, antiplasmodial (such as Plasmodium falciparum), antidiabetic, antioxidant, and anti-inflammatory (Immunomodulatory) activity. Plants-containing Liriodenine in the world is abundant, not limited to Annonaceae, Magnoliaceae, Lauraceae, Menispermaceae, and Rutaceae. So Liriodenine prospective for developing as herbal therapy or single
compound for Covid-19 diseases

The Internet of Things (IoT) might be a state of affairs during which objects, animals or individuals were furnished with the distinctive identifiers and thus the power of transfer knowledge over the networks are not
needed the human-to-human or human-to-computer interaction. IoT has involved from the concentration of wireless technologies and the internet . Internet of issues are the connection of something with the opposite objects the connection was mainly transmitted of use during a position knowledge, as an example a detector during a very space to observe and management the temperature. To elucidate a security alarm victimization was small process power chips victimization internet of things that helps to observe the acquire alarm. Once the motion is detected and sends photos and videos to a cloud server. Moreover, internet of things- is based on applications are going to be used distant to seem at the activity and acquire notifications once motion is detected. The photos and videos are receive on a cloud server, once the cloud isn't on the market then the knowledge is keep regionally on the Raspberry Pi and sent once the association resumes. If user documented as unknown person through GSM, then shock are getting to be created on the unknown person. If user itself desires to enter home, the system can acknowledge with the face detection then system permits the person to enter. Therefore, benefits like these build this application ideal for watching homes in absence.

Brain abscess rarely occurs in a patient with hematologic malignancy. Leukemia is the most common hematologic malignancy and can manifest to CNS as cerebrovascular complications, infections, or metastatic brain tumors. Brain abscess in a patient with leukemia has an unspecified presentation, makes challenging diagnosis processes, and contributing to increased mortality and morbidity. We report and describe in detail an unusual case of a 44-year-old man with brain abscess and ALL. Specifically, the patient underwent a series of tests, brain MRI, and MR Spectroscopy. The results of the tests are reported here. We discuss the occurrence, the clinical presentation, and association between these two diagnoses, possible etiopathogenic mechanisms, management, and prognosis of this condition.

Quality of Work Life is the extent to which human resources are capable to shape their career vibrantly, in accordance with their opportunities, needs and interests. It is also amount of power that an employer provides to its employees to draft their works. The aim of the study is to investigate the impact of job performance on quality of work life and to find out if there is an quantitatively demonstrable relationship among these two variables. This quantitative research was carried out on 600 research samples from engineering colleges in Tamilnadu. Statistical tools, such as Factor analysis and Regression analysis were used to analyse the data. The findings of the study indicate the clear impact job performance has on quality of work life. The results of the study further prove that the change in Job Performance factor explains the changes in quality of work to the extent of 84.11 percent. The significant ‘F’ statistics reveals the validity of the regression model. Hence job performance impacts quality of work life to greater extent.

Introduction: Catheter-related bloodstream infection (CRBSI) is a critical problem in dialysis
center.
Aim: To study the prevalence of central venous catheter related blood stream infections and to
identify the microbiological profile of organisms causing CRBSI.
Materials and Methods: This prospective observational study carried out at Dialysis unit over
a period of two years on 145 hemodialysis patients, who had cultures of catheter and blood
samples were studied.
Results: A total of 557 haemodialysis catheters (tunnelled and non-tunnelled) were
inserted during the study period, and among them, CRBSIs was seen in 145 cases.Mean
duration of dialysis catheters in situ was 20.6days.99 (68.2%) patients were males, and 46
(31.7%) were females. Diabetes mellitus (76.5 %) was the most common premorbid illness
associated with CRBSI. 81.3% patients found to be below 10 mg/dl of Hb, and
68.3%patients had leucocytosis. Among 145 of CRBSI, blood cultures were positive in 48
patients, and 97 patients were culture negative.45.8% isolates were gram-positive and
52.8% isolates were gram-negative bacteria, and one isolate was found to be fungal
infection.Among gram positive, CONS were most isolated, followed by Enterococcus,
MSSA and MRSA.

Men and women have got equal status in India which is very much reflected in the Constitution of India. Especially women are considered as the wealth of our country who are leading the country and making all of us proud. However, there is still systematic discrimination prevailing in our society which leads to some kind of disregards such as lack of nutrition, low literacy rate, property rights, women trafficking, child labour and domestic violence etc. There are many fears which entangle the freedom of women too. Sexual violence is one of the most ruthless distress that encompasses fear in women. The hypothetical question is whether this condition is predominant due to any unequal distribution of powers among sexes? Media is the fourth pillar of our democracy hence, its coverage and reports are imperative for democracy. Media plays a significantly vital role to influence the masses. The new intrusion of digital media revolution further adds more clout to media. Regrettably, it has been witnessed that the role of media is decisively wavering from showing the real news and conveniently presenting biased and onesided information in the name of news. The Unequal portrayal of women in media is irony. The sensitization of gender issues is the need of the hour as it is an inevitable factor in women empowerment. This paper broadly focuses on these above aspects highlighting the contemporary issues on women and the role of media

Неправильное и нерациональное использование противомикробных препаратов в ветеринарной практике приводит к быстрому формированию устойчивых к антибиотикам штаммов патогенных микроорганизмов, что снижает их роль как лечебно-профилактического средства. В то же время у микроорганизмов часто  развивается множественная устойчивость, то есть устойчивость ко многим антибиотикам. Для выбора средств эффективной антимикробной терапии и профилактики важно определить чувствительность выделенных культур возбудителей к антимикробным препаратам. Чувствительность микроорганизмов к
антибиотикам необходимо определять в каждом случае заболевания животных

 
For many years, the value of safety management practice has been the subject of research attention in many sectors in Malaysia in order to achieve a positive workplace safety climate. The practice of safety management among accredited centers in the education sector, however, has hardly been examined. This study was therefore conducted in Johor, Malaysia, to investigate the elements of the safety management practices in the Technical and Vocational Education Training (TVET). This research included seven participants consisting of safety and health (SH) coordinators from each accredited TVET center in Johor, Malaysia. Via interview data collection, this study used the full qualitative approach. The outcome of the thematic analysis showed that there are ten key elements of safety management practices that have become factors among accredited TVET centers in Johor, namely management commitment, safety policy, safety committee, instructor involvement, safety rules and procedure, safety training, safety audit, risk management, communication and feedback and also safety promotion. The accredited center is advised to pay attention to these ten elements in order to improve safety management practices in the TVET sector.

In medical technology, Magnetic Resonance Imaging (MRI) has been used widely for detection of tumors and diagnosing various abnormalities in tissues. In scientific research, a major role has been played by the active development in the computerized segmentation of medical image. Based on fast decision making, the doctors can take required treatment easily. In the information technology, the segmentation of brain tumor is a key point. By
analysing the radiation therapy treatment, tumor growth, computer-based surgery, developing the growth models of tumor, and treatment responses, the segmentation of brain tumor is motivated. For segmentation of brain tumor, a deep learning-based framework is presented. To achieve the robust performance through a majority rule, deep learning based semantic segmentation architecture is used for segmentation of tumor that can improve the performance effectively

In recent years, digital images have a large variety of uses and for different purposes. The most significant and common form is called digital image forgery, which uses the same image in the forgery process, and we have many kinds of image forgeries. For creating a duplicate or hiding any existing objects, a region of an image copies and paste into the same image. For a forgery with particular form, the images are tested in this paper. Images will first be split into super pixels to detect the forgery attack. Because of the high dimensional existence of the feature space, the representation of reduced dimension feature vector is achieved with the implementation of hybrid function point mapping. During the feature matching, the efficiency is also improved. In order to identify the forgery in the picture, the suggested system is successful. The proposed method therefore offers a detecting forgery with efficiency and efficacy that helps to improve the image authenticity in evidence-centered applications.

As cloud computing has become an incredibly important task in real life, security of privacy in many areas, in especially in the context of Personal Health Record (PHR), has indeed been given growing attention. The traditional encryption based on ciphertext policy (CP-ABE) allows you to control the scrambled PHR information policy in a fine-grained manner, however the accessing policy is also sent with the cipher text. The entry policy, however, cannot activate the anonymity of users, as it includes an excessively large number of confidential information from valid users of software. It is now important to ensure the privacy of users through hiding access strategies. The overwhelming majority of previous plans however have to deal with two problems: (1) certain plans do not accept a wide universe of the attributes, hence their common sense in PHR is considerably reduced and (2) the decryption costs are very high because the entry scheme is set up in cypher text. Their utility is thus drastically limited. To resolve these problems, we create a CP-ABE plot with proficient decryption, where both the scale of available parameters and the cost of decryption are steady. In addition, by using the dual system encoding technique, we demonstrate that the proposed conspire achieves full safety in the standard model.

The study focuses on the analysis of the impact of COVID-19 situation on the automobile industry worldwide. The study includes analyzing the responses of customers and their views on the current pandemic situation and its impact of the covid-19 situation on the automobile sector.

The plight of Dalit women in the Indian society as depicted in karukku is sad and labeled with considerable gloom. They are oppressed on the basis of caste, gender as well as class. Karukku very significantly raises questions on caste and religious issues that damage our society. Bama’s fictional writings delineate several issues of violence on Dalit women, wife-beating, sexual harassment, loneliness, women abandoned by their husbands, ignorance, etc at their own homes within the community. In a larger outlook, her literary works portray the marginalisation and exploitation of Dalit women as well as the whole community at the hands of upper class society. They are socially and economically exploited by the upper castes people. Through this autobiographical novel, Bama attempts to reflect, especially her own sufferings both within and outside her community, the sufferings of Dalit women and the everyday social reality of her community. She tries to project the social reality of Dalit women who struggle every day for their survival. The present paper is on the basis of patriarchal rules in which women have to go through the rules made by the male members of a family or society. In that case, women are compelled to go through the tough roads made for them, they are segregated, separated and become as ‘other'. Because of the strict customs prevailing, they cannot speak of their own and finally become subalterns. This study reflects on the issues of women portrayed in the select text. It is highlighted in terms of class, caste and religion with proper lens of subaltern context.

The success of root canal treatment depends on thorough disinfection of the root canal system, and to provide fluid impervious seal which in turn halt the progress of the periapical infection. The oral microorganisms from the degenerated pulp tissue are responsible directly or indirectly for most of the periapical lesions. For the treatment of these lesions there are surgical and non-surgical methods. Surgical removal of the periapical lesion without proper root canal disinfection and obturation will result in improper healing of lesions whereas in non-surgical root canal therapy the lesions heal if proper cleaning, shaping and obturation of root canal are done. This clinical case series highlights the follow-up results of three cases demonstrating the resolution of periapical lesion through nonsurgical approach and confirms that periapical lesions respond favorably to non-surgical treatment

Introduction: Primary teeth have an important role in directing the eruption of permanent teeth. Premature loss of primary teeth can lead to unwanted tooth movement resulting in loss of space in the permanent teeth. Space maintainer (SM) is a tool-based process that plays an important role in preventive and interceptive orthodontics during the start of primary teeth or premature loss in developing teeth. Space maintainer (SM) has been used when there is premature loss of primary teeth to avoid unwanted teeth movement and loss of arch length.
Objective: To explore the use of spaca maintainers in pediatric dentistry. Methods: In the systematuc riview, the article search was performed on Pubmed, Elsevier, and Google Scholar. Study published on 2013 to 2020. 60 were articles assessed, including 60 articles from the electronic databases, 0 from the manual hand search. 50 records screened, 30 records excluded, 22 full-text articles assessed for eligibility and 15 full-text articles were
included. Results: There were 15 articles about the use of spaca maintainer in pediatric dentistry. Conclusion: Based on 15 articles show that space maintainers are used in pediatric dentistry to preserve the space left by primary teeth that were extracted before the date of the teeth being removed.

Soft tissue sarcomas (STSs) are a typical group that differs from one of the tumours with distinct histopathological subtypes. It is estimated in 21% of all malignant diseases in children, and less than 1% of all adult malignancies [1] Adjuvant radiation is well-established for the conservative treatment of soft tissue
sarcomas. The National Cancer Comprehensive Cancer Network guidelines recommend that postoperative radiotherapy be administered to most patients with sarcomas of the soft tissues of the extremities and upper extremity. When only low-dose (LDR) brachytherapy (BT) is used, 45-Gy doses are used in patients with severe oedema. In cases where margins are positive, a combination of 50 Gy beam radiotherapy (EBRT) and 16-20 Gy of LDR brachytherapy or equivalent high-dose rate (HDR) is warranted. This range of radiation concentrations produces a five-year cell control rate of 75-90% [3 - 14]. LDR brachytherapy has been a frequently used method [15 - 23], and reports of high-dose (HDR) brachytherapy are very small in number [24 - 27]. However, HDR brachytherapy is widely used due to better compliance with radiation safety policies, more complex radiationplanning and the possibility of outpatient treatment.

Background: Oral health is a part of general health and hence, has a direct bearing on the total well-being of individuals. Knowledge of oral health status and treatment needs of populations with different characteristics is important for developing appropriate preventive approaches.
Aim: The aim of the study is to determine the relationship between oral hygiene with socioeconomic status among 15 years old school going children of Lucknow city. Materials &
Methods: A descriptive cross-sectional study was conducted. The schools were selected by simple random sampling method following the lottery method of selection. Simplified Oral Hygiene Index with Kuppuswamy’s socioeconomic status scale has been used. Results: As socio-economic status decreases; mean OHI-S increases. Comparing the mean OHI-S between different SES groups, ANOVA revealed significantly different OHI-S among the groups (F=38.84, p<0.001). Conclusion: The mean scores of OHI-S revealed a significant relation with socio-economic status. It was reported that as the socioeconomic status decreased, oral hygiene status of the children deteriorated.

Spontaneous esophageal rupture is a rare clinical condition, occurs most often in the lateral,
lower 1/3 of the esophagus and is associated with a mortality rate of 20–75%. As a result of
these nonspecific findings, Spontaneous esophageal perforation is often misdiagnosed as an
aortic emergency, pericarditis, myocardial infarction, pulmonary embolus, spontaneous
pneumothorax, perforated peptic ulcer, or pancreatitis .We outline 6 cases of spontaneous
esophageal perforation came to our institution and will discuss about their diagnosis ,required
interventions ,complications and 2-year follow up.

Because child-care teachers in Korea have heavy workloads and worse treatment than in other teaching positions, their job stress level and turnover rate are high. There is a need for research to alleviate the turnover rate of child-care teachers. Therefore, our purpose was to verify the roles of grit in the influences of job stress on turnover intention through emotional commitment and job satisfaction of Korean child-care teachers. We used SPSS Win. 25.0 and PROCESS macro for SPSS version 3.5 programs to carry out frequency analysis, reliability
analysis, correlation analysis, and moderated mediation effect analysis. First, as a result of correlation analysis, there was a statistically significant correlation between all variables. Second, the moderated mediating effect of grit on the double mediating effect of emotional commitment and job satisfaction in the link between job stress and turnover intention was verified. This results can be used as a basic model using grit to reduce child-care center teachers’ turnover intention

Chronic kidney disease (CKD) is related to poor oral health, including gingival and periodontal diseases. Poor oral health in CKD patients is an important problem, but often neglected. Oral health status also associated with the individual's Oral Health Behavior (OHB). The aim of this study is to assess the impact of OHB on gingival health status in CKD patients.

The implementation of standard Integrated Management of Childhood Illness (IMCI) is still experiencing problems in the field. One of the contributing factors is the lack of knowledge, skills, and experience of health workers in optimally handling illness infants or toddlers. The purpose of this study was to identify the effect of training in the management of illness toddlers with the IMCI approach on the behavior of health workers in the management of illness toddlers. This study used a Quasi-experimental research design using a pre-post-test design with one group. Thirty health workers were a participant on duty at the Medan Sunggal Public Health Center using purposive sampling. Data were collected by a demographic data questionnaire, and questionnaire on knowledge, attitudes, and observation sheets to measure actions about IMCI. The univariate analysis was descriptive statistical analysis to present the characteristics of the respondents and the behavior of health workers in handling illness childhood under the IMCI approach. The bivariate analysis was inferential statistical analysis,
namely, the Wilcoxon test was used to compare the behavior of health workers in handling illness childhood with the IMCI approach before and after being given IMCI training. The results showed that the management training for illness toddlers with the IMCI approach was effective for the knowledge of health workers in the management of illness toddlers (p-value 0.0001), the training for the management of illness toddler with the IMCI approach was effective for the attitudes of health workers in the management of illness toddlers (p-value 0.0001). Training on the management of illness toddlers with the IMCI approach was effective for the actions of health workers in the management of illness toddlers (p-value 0.0001).

Carcinoma cervix is the 4th most commonly diagnosed cancer in women and 10th overall worldwide. There were 569,847 new cases and 311,365 deaths from cervical cancer worldwide which accounts for 7.5% of total number of cancer deaths in women. 1 Cervical cancer is the 2nd most common cancer among Indian women aged 15-44 years with an estimate of 1,23,000 incident cases and 67,000 deaths in 2013 .2 The choice of treatment depends on staging. Treatment planning i.e. Radiotherapy for cervical cancer consists of EBRT (external beam radiotherapy) along with concurrent chemotherapy followed by Intracavitary irradiation (ICRT) .3 External beam radiotherapy can be provided in the form of conventional (2 D), 3 dimensional conformal and intensity modulated techniques.

Cobalt Oxide and Zinc Oxide nanoparticles were synthesized using extract of Annona muricata (sour soup), leaves as a stabilizing and reducing agents. Cobalt Nitrate and Zinc Nitrate as a precursor. Green method was applicable because low cast, sustainable and ozone friendly. Synthesis of polymer metal Nanocomposites of Cobalt Oxide fictionalized in starch and Zinc Oxide functionalized in starch by using solution casting method. The percentage of Cobalt Oxide and Zinc Oxide Nanoparticles were varied from different concentrations (0. 01, 0. 02, 0. 03,0. 04 with the starch (0. 3,0. 4, 0. 5,0. 6). Structural and Composition of these nanocomposites were characterized using UV-Visible, FT-IR,SEM, and XRD. The biological studies of the above composites were evaluated in vitro by using surface inoculation and disc diffusion method. Photocatalytic property of the nanocomposites have investigated by methylene Blue as a dye.

Evaluation of Patient satisfaction level who are getting admitted through emergency
department (ED) is very necessary because it affects the performance that reflects the
high quality, efficiency, and sustainability.
Aim:
To assess the level of satisfaction in various points among inpatients following 48 hours
of their admission through the emergency department.
To find out the quality indicators of patient care through emergency department care
Methods:
This quantitative cross-sectional study was conducted in the emergency department. The target
population was who have been admitted through the emergency department. The data was
collected after 48 hours of admission in to the hospital.
Result:
Total of 98 patients were participated in this study and shared their experiences through a
standard questionnaire. Total percentage of highly satisfied patients was 60.2% (n=59) for the
services given by the emergency department. Total percentages of satisfied patients were 22.4
%(n=22) and Similarly each of both highly dissatisfied and dissatisfied patients were 2, and
neutrals are 13.3 %(n=13).
Conclusion:
Satisfaction level of patient carries the total image of the hospital. It is also a good quality
indicator which enables the contact points of improvement in ED so that the hospital can
provide better care and services to the patients.

Chronic obstructive pulmonary disease (COPD) is a chronic lung disease characterized by progressive non-reversible or partially reversible obstruction of airflow obstruction in the airways. This study aimed to determine the effect of a combination of upper and lower limb resistance training on respiratory rate and oxygen saturation in
patients with chronic stable obstructive pulmonary disease undergoing medical rehabilitation programs. The study used a quasi-experimentaltwo-group pre-test post-test. The samples were selected by consecutive sampling technique.Data were analyzed using descriptive statistics, paired t-test and independent t-test.The mMRC scale was obtained the most at mMRC1.The frequency of patients with pulmonary function disorders in obstruction in the moderate category was 55.6% in the treatment group and 66.67% in the control group. Restrictions in the moderate category were 55.6% in the treatment group and 61.11% in the control group and the most Brinkman Index values were in the weight category of 55.6% in the treatment group and 72.22% in the control group. Respiratory frequency and oxygen saturation in the patient obtained a value of 91.38±2.25, then the oxygen saturation value decreased for a certain time to be 90.22±0.51. Whereas in the treatment group it was 92.06±2.88 while after the exercise it became 95.72±2.32. This study concludes that there is an effect of the combination of upper and lower limb resistance training on respiratory rate and oxygen saturation in patients with Chronic Stable Obstructive Pulmonary Disease.

Background: Blood pressure (BP) levels variety throughout the day, both by internal stimuli and the influence of external factors. The BP which measured at the clinic are higher than self measurement at home. Deep breathing (DB) is a technique which deep breaths <10x/minute,which can lower BP through activation of chemoreceptors and baroreceptors. The aim of this study is to know the effect of DB on systolic blood pressure (SBP) and diastolic
blood pressure (DBP) in the normo-prehypertensive population

This study conducted to obtain the problems of undergraduate student problems as well as for construct validation and internal consistency of the problem source, which later couldused as a valid and reliable instrument to identify the source of problems among undergraduate students. The cross-sectional study conducted on 704 students in 14 faculties. The making and development of questionnaires conducted based on student complaints during counseling at the Clinic at campus and literature study, and obtained 50 items. Construct validation and internal consistency carried out confirmatory factor analysis using structural equation modeling in Lisrel software application and grouping carried out using analysis factor in SPSS software application. Results of structural equation modeling validation using the t-test obtained 24 valid variables with t values ≥ 1.96. The results of analysis factors obtained 5 factors that are the problem of communication and adaptation, academic, personal, emotional, and disappointment. The study results suggest that it is necessary to introduce campus adaptation programs/activities, introduction of teaching and learning activities, communication workshops/trainings, mentoring from seniors to help communication and adaptation between friends, faculty staffs and lecturers.

Background:Reading radiographic images for Covid-19 identification by an expert radiologist requires significant time, therefore the development of an automated analysis system to assisting and saving time in diagnosing Covid-19 is important.
Objective: The purpose of this study is to implement the GoogleNet architecture with various epochs in hope achieving higher level of accuracy in Covid-19 detection.
Methods: We retrospectively used 813 images, i.e. 409 images indicating Covid-19 and 404 normal images. The deep TL model with GoogleNet architecture was implemented.The training was carried out several times to get the best acquisition value with a learning rate of 0.0001 for all levels. The network training was carried out with different epochs, i.e. 12, 18, and 24 epochs, and each epoch with 65 iterations.
Results: It was found that accuracy was determined by changes in the number of epochs. The classification accuracy was 96.9% in epoch 12, 98.2% in epoch 18, and 99.4% in epoch 24.
Conclusion: An increase in the number epochs increases the accuracy in the detection of Covid-19. In this study, the accuracy of the method reached 99.4%. These results are promising for the automation of Covid-19 detection from radiographic images.

Background: Adolescent health is important as theyare under a great amount of stress due to academic and peer pressures. This study aims to determine prevalence of pre-hypertension and hypertension in school adolescents and to identify diet as a risk factor in these children.Methodology - Cross sectional study was conducted among school adolescents(11- 14years). Anthropometric and blood pressure measurements were taken. 24 hour recall method was used to record the dietary intake and the total sodium, potassium, fat, fructose, caffeine, uric acid and fiber in the diet was estimated. Results - 500 adolescents were studied. Among the study population 6.4% were pre-hypertensive and 7.4% hypertensive with increased prevalence in girls. 9.8% were obese and 14.2% overweight. 14.3% obese and 11.3% overweight children had pre-hypertension. 30.6% obese and 9.9% overweight children had hypertension. Dietary analysis showed that normotensive children consumed lesser fructose (258mg), fat (12.8gm), sodium (89mg), and uric acid with more potassium (89mg), and fiber (10.2gm) per day as compared to the hypertensive children. Conclusions: There is high prevalence of asymptomatic hypertension among obese and over-weight school adolescents. Dietary differences were found between the hypertensive and normotensive adolescents with increased fat consumption showing statistical correlation with hypertension

It follows from the data studied that information on the content of chemical elements in animal hair, depending on the presence of melanin, should be related to the concentration of this pigment, before judging the effect of environmental factors on their content. For a long time it was assumed that, the entry of mineral substances into the hair occurs from the blood capillaries, which are supplied to the hair follicle bulbs and the epithelial layers of the skin. There have been attempts to establish a positive correlation between the content of mineral and organic substances in the blood. When comparing the reaction of blood plasma and rat hair to a change in the composition of food, it was found that plasma quickly responds to changes in the content of magnesium and calcium in the diet, slowly - to the content of phosphorus and does not react at all to changes in the level of sodium and calcium (this is explained by a clear homeostatic regulation of the content of these elements in the blood). At the same time, the hair reacts quickly to changes in sodium content, slowly to calcium, magnesium, phosphorus, and very slowly to changes in potassium concentration.

The well-known acoustic schemes [1,2,3,4], which are typical for various cars, and mathematical expressions that allow describing the process of the formation of the sound field, convincingly show that the sound field on the outer surfaces of the cab rails is unevenly distributed. All known methods and formulas for calculating the effectiveness of soundproof cabins for various purposes are given in [1,2,3,4], take this unevenness into account when determining the total value of the sound intensity in the cab. However, the works listed above didb not consider the development of a sound and vibration-insulating cab, taking into account the unevenness of the sound and vibration fields.

The experiment was conducted to know the of micropropagation efficiency of Tr10, Vishala, M5 and G2 mulberry (Morus spp.) varieties using leaf and nodal explants. Regeneration and multiple shoot formation were achieved from the callus phase from four mulberry varieties via Tr10, Vishala, M5 and G2. MS medium fortified with different concentrations and combinations of growth hormones were used, such as alone 2, 4 D (0.5 mg/l - 2.5 mg/l) and in combination with BAP (0.5 mg/l and 1.0 mg/l) for callus initiation from leaf and nodal explants. Shoot buds developed from callus were transferred to the multiplication medium containing BAP (0.5 mg/l – 3.0 mg/l) and NAA (0.1 mg/l) combination of growth hormones. The micro shootlets were subcultured to obtain sufficient growth of the shoots. Then shootlets were transferred to the rooting media containing NAA and IBA (0.5 mg/l – 3.0 mg/l). The results indicate that explants inoculated in alone 2, 4 D has enhanced the callus formation percentage. The best callusing was observed from nodal explants in alone 2, 4 D at 2.0 mg/l concentration in most of the varieties. Whereas the leaf explants did not show any further regeneration and proliferation was ceased in callus phase

Background: Exposure to wood dust reduces the pulmonary function and it may cause inflammation and oxidative damage. A correlation of the biochemical parameter to the spirometric values of lung function parameters may be useful in selecting an alternative test parameter to assess lung function in conditions where performing spirometry is difficult.
Objectives: Assessment of biomarker of oxidative stress, malondialdehyde (MDA), and inflammatory marker, c-reactive protein (CRP) along with pulmonary function test parameters, forced expiratory volume at first second (FEV₁), forced vital capacity (FVC) and their ratio (FEV₁/FVC) in sawmill workers and comparing with non sawmill workers.Correlation of biomarkers with pulmonary function test results.
Methods: Spirometric measurements were taken by advising the subjects to breathe through the instrument. Serum MDA and CRP were estimated in the collected blood using standard procedures.
Results: Significantly elevatedSerum MDA and CRP and lower lung function parameters, FEV₁, FVC and FEV₁/FVC were observed in sawmill workers compared to non sawmill workers. A significant positive correlation was observed between FVC and MDA with CRP. FEV₁/FVC showed a significant negative correlation with MDA.
Conclusion: Serum MDA and CRP were high in sawmill workers. Serum MDA may be used as an indicator of reduced pulmonary function in case of difficulty in performing spirometry

Primary Education means education that is first formally imparted to children. Primary education is imparted in two types of schools- Primary school and upper primary school. In 1937, the outline of basic education was presented by Mahatma Gandhi in Vardha conference. It is currently known as primary education. Various commissions and schemes for the improvement and spread of primary education of independence were implemented. The major schemes are Sarva Shiksha Abhiyan, DPEP, Operation Black Board and Middle day Meal Scheme. The middle day meal scheme was inaugurated from 15 August 1995. The objective of starting the program in the early stages was to increase enrolment, retention and attendance as well as to improve nutrition levels in children. But despite almost 30 years of implementation of the Mid-Day Meal programme, there has been an improvement in student enrollment and retention, but there is still a need for relative improvement in student’s class attendance and their nutritional level.

Objective: Abutilon indicum is an ethnomedicinal plant that has several medicinal claims and it hasn't been explored thoroughly. Various parts of the plant are used medicinally such as demulcent, aphrodisiac, laxative, diuretic, pulmonary disorders, etc. The study aims to explore the different qualitative, quantitative, and antifungal aspects of Abutilon indicum.
Materials and methods: The present study was conducted to evaluate the anti-microbial activity of Abutilon indicum extracts against Gram-positive bacteria (Staphylococcus aureus), Gram-negative bacteria (E. coli), and Fungal (Candida albicans). The agar well diffusion method was used to test the antimicrobial activity.
Result & Discussion: Abutilon indicum extracts exhibited potent antibacterial and antifungal against all the selected bacterial and fungal species. The extracts exhibited the growth inhibitory activity in a dose-dependent manner. Also, the study revels  Abutilon indicum shows good antimicrobial and anti-fungal activity.
Conclusion: The Abutilon indicum. plant extracts could be used as an antimicrobial after comprehensive in-vitro biological studies.

Objective: Phyllanthus emblica is an ethnomedicinal plant that has several medicinal claims and it hasn't been explored thoroughly. Various parts of the plant are used medicinally such as antioxidant, anti-inflammatory, analgesic and anti-pyretic etc. The study aims to explore the different qualitative, quantitative, and antifungal aspects of Phyllanthus emblica. Materials and methods: The present study was conducted to evaluate the anti-microbial activity of Phyllanthus emblica extracts against Grampositive bacteria (Staphylococcus aureus), Gram-negative bacteria (E. coli), and Fungal (Candida albicans). The agar well diffusion method was used to test the antimicrobial activity. Result & Discussion: Phyllanthus emblica extracts exhibited potent antibacterial and antifungal against all the selected bacterial and fungal species. The extracts exhibited the growth inhibitory activity in a dose-dependent manner. Also, the study reveals Phyllanthus emblica shows good antimicrobial activity. Conclusion: The Phyllanthus emblica plant extracts could be used as an antimicrobial after comprehensive in-vitro biological studies. KEYWORDS : Phyllanthus emblica, Anti-microbial, Staphylococcus aureus, E. coli, Candida albicans.

Inflammatory cells may reach significant levels in blood in different type of cancers.Neutrophil Lymphocyte Ratio(NLR) and Platelet Lymphocyte Ratio(PLR) arecosteffective and universally available.So this study was planned to assesthe efficacy of NLR and PLR along with Risk of malignancy Index(RMI- II) in differentiating benign and malignant adnexal masses preoperatively

In this paper catalytic vinylation of morpholine with the acetylene at atmospheric pressure with formation of N-vinylmorpholine has been investigated. The influence of nature of catalysts and solvents on vinylation of morpholine in homogeneous conditions is studied. DMSO is chosen as optimal solvent and the effect of temperature influence and amount of catalyst for the vinylation process are investigated. Role of high-basic system KOH/DMSO and its nucleophilic interaction with acetylene has been shown and kinetics of morpholine vinylation is investigated. Heterogeneous catalytic vinylation of morpholine with acetylene in presence of catalysts KOH/AC-L and nanostructural KOH/activated coal has been investigated. Nanostructured KOH/activated coal catalyst proves more effective in the formation of Nvinylmorpholine.

Chronic bacterial prostatitis is a persistent infection of the prostate characterized by frequent relapses due to incomplete eradication of the causative organisms, with a negative impact on patient’s quality of life. This study aimed to determine the most common bacterial causative agents and their antibiotic sensitivity patterns in patients with chronic bacterial prostatitis in Duhok, Kurdistan, northern Iraq. A standardMeares-Stamey four-glass test was performed for all males presenting with chronic prostatitis symptoms for more than 3 months. Men with high leukocyte counts and bacterial growth inexpressed prostatic secretion (EPS) and post-prostate massage urine (VB3) samples but negative first-voided (VB1) and midstream urine (VB2) samples were included in the study. The Phoenix system (Becton Dickinson) was used for bacterial identification and antimicrobial susceptibility testing.Staphylococcus spp. were the most prevalent microorganisms in patients with chronic prostatitis (60.8%), followed by Escherichia coli and Enterococcus spp. (13.7%).Most patients with chronic prostatitis who were diagnosed with Staphylococcus spp. exhibited high resistance tobenzylpenicillin (75.0%), oxacillin (60.5%), and ampicillin (59.0%). Patients diagnosed with Enterococcus spp. showed high resistance to quinupristin-dalfopristin(20.0%), cefoxitin screen (15.7%), clindamycin (16.9%), tetracycline (16.9%), and rifampicin (17.1%). Among those diagnosed with Streptococcus spp., most had resistance to oxacillin (7.4%), tobramycin (8.0%), erythromycin (8.4%), clindamycin (8.4%), tetracycline (8.4%), and mupirocin (12.1%).The patients with E. coli had resistance to extended-spectrum β-lactamases (ESBL)(45.5%) and cefepime (25.0%). In summary, we found that the most prevalent pathogens from patients with chronic bacterial prostatitis are E. coli, Enterococcus spp., and Staphylococcus aureus. Gram-positive isolates showed the highest resistance to benzylpenicillin, fosfomycin, ampicillin, tetracycline, rifampicin, and mupirocin. Moreover, gram-negative bacteria were most resistant to ESBL, cefepime, and ampicillin-sulbactam. To manage this condition, physicians should take into consideration the development of multi-drug resistance among the pathogenic agents.

Background: A new conception is emerging by acknowledging that right breathing volume is elemental for good health, based on the devotional work of Russian scientist Konstantin Buteyko. Buteyko breathing technique (BBT) is committed to reduce pulmonary ventilation which raises the levels of carbon dioxide in the body. Thus, it increases oxygen delivery to the tissues and cells.
Objectives: To analyse the effectiveness of the Buteyko Breathing Technique on physiological and psychological parameters of football players.
Methodology: 40 male footballers were included in the study and randomly divided into two groups. Group A (n=20) received 6 weeks BBT (5 sessions/week) where as Group B (n=20) continued with regular training. Resting Heart Rate (RHR), Resting Blood Pressure (RBP), VO2max, Control Pause Test and Anxiety were measured at the beginning and after the completion of the protocol in both the groups.
Results: Paired t test revealed a significant decrease in RHR, and Anxiety by 5.76% and 12.4% respectively. Resting Systolic and diastolic blood pressure decreased by 4.26% and 5% respectively, whereas massive improvement was seen in Control Pause by 134.2% and VO2max by 15.54% in Group A. No significant change was seen in group B. Conclusion: BBT was found to be useful technique to enhance endurance of the players as it
has showed a positive improvement in cardio respiratory parameters. This technique was also helpful in reducing anxiety

INTRODUCTION COVID-19 is an emerging infectious disease with etiology severe acute respiratory syndrome corona virus-2 (SARS-COV-2) which is causing various clinical manifestations not only in the respiratory tract. COVID-19 declared as a pandemic that causes high mortality worldwide. Simple examination modalities are needed to help diagnose COVID-19. This descriptive case report has aims to show the role of monocyte count to help establish the diagnosis of COVID-19.
METHODOLOGY This is a case report from confirmed COVID-19 cases in RS Bhayangkara Brimob. Data will be presented according to the descriptive method. RESULTS52 confirmed cases from April 2020 until May 2020 were used in this research, consist of 42 (81.13%) male patients and 10 (16.87%) female patients. 34 (65,38%) patients had an increase in monocyte count. Of 45 symptomatic patients, 29 of them (64.44%) were known to have monocytes> 7. Of 17 confirmed positive patients who shown unilateral and bilateral infiltrate, 13 of them had an increase in monocyte count, 1 patient(100%), and 12 (26,67%) patients, respectively.
CONCLUSIONS From the data, we conclude that simple laboratory result parameters such as lymphocyte, sedimentation rate, particularly monocyte, help to establish the diagnosis of COVID-19.
This is based on increasing monocyte in mostly all confirmed COVID-19 patients involved in this study.

Background: Gall stone disease (GSD) being rare in children needs particular attention. Gallstones, when associated with bile duct stones, require ERCP and clearance of bile ducts. The safety and periprocedural course of ERCP and cholecystectomy in children with gall stone disease along with choledocholithiasis have sparingly been studied previously. Material and methods: We did a retrospective analysis of the data retrieved from electronic healthcare records. This data comprised demographic, laboratory, details of ERCP, cholecystectomy and periprocedural course of the patients. Results: In our centre, 43 children underwent cholecystectomy from April 2015 to May 2020. Open cholecystectomy (OC) and laparoscopic cholecystectomy (LC) were performed in two and forty-one children. All patients were symptomatic at the time of presentation, recurrent biliary colic being the most common symptom. Among the 43 children, four children and seven children were obese and overweight,
respectively. The only significant risk factor accountable for gall stone disease was obesity. Preoperative ERCP was required in 7 patients; among them, 2 had cholangitis. No significant complications noted in any of the children who underwent ERCP. Conclusion: ERCP is a safe therapeutic tool for choledocholithiasis in children, as it is in adults. ERCP followed by cholecystectomy in children is the most common technique for addressing combined gall bladder and bile duct stones. Cholecystectomy is useful in children with typical biliary symptoms. The only significant risk factor for GSD in our patients was obesity

Background: The BCR-ABL mutation types were reported influencing the treatment of
Chronic Myelogenous Leukemia (CML) due to different responses to the use of tyrosine
kinase inhibitor. However, the clinical score system, that is, EUTOS score is also
considered as one essential factor in determining the treatment outcome. This study aims at
observing the hematology response among chronic phase CML patients atSardjito Hospital
Yogyakarta, Indonesia based on BCR-ABLmutation types, namely b3a2 and non-b3a2,
with evaluation of EUTOS scores.
Methods: A retrospective cohort of 72 subjects from January 2013 to November 2018 was
analyzed according to mutation types and EUTOS scores to observe the hematological
response within 6 months after initiation of Imatinib therapy.
Results: Forty-eight subjects (66.7%) had b3a2 mutations, while others had non-b3a2
mutations. The median of spleen size was significantly higher in non-b3a2 mutations (p =
0.024). Only 49 subjects (68%) achieved the complete hematological response (CHR) within
6 months. The non-b3a2 mutation subjects were likely to have worse clinical and laboratory
profiles than the b3a2 mutation subjects did (p > 0.05). The b3a2 mutation subjects tended
toachieve earlier CHR than non-b3a2 mutation subjects (HR 1.031; p = 0.919). The latter
subjects with high EUTOS scores had longer time to achieve the CHR (p = 0.781).

Objective:A systematic review of the existing literature was done to evaluate the effects oftherapeutic extraction of first and second premolar on mandibular plane angle and in turn on
the vertical facial dimension.
Methods: Electronic database searches (MEDLINE, EBSCO host and Google Scholar) of published literature were performed with no publication date or language restrictions followed by manual searches for eligible studies. Extraction of data was done independently and in duplicate by two authors.Risk of bias was assessed using Cochrane's tool, ROBINS-I (Risk of bias in nonrandomized studies – of interventions).

Background. The paper presents data on the variability and relationship of microorganisms in the biocenosis of livestock farms. Methods. The analysis of the available literature on the formation, operation, correction, and diagnosis of biocenoses of livestock farms. Results. It is shown that the animal organism is constantly exposed to the environment. A special place among the environmental factors affecting the animal body is microorganisms – causative agents of infectious diseases. Survey available of the literature on the evolution and relationship of microorganisms in different natural habitats. So, in the process of evolution to parasitism in tissues and organs of animals have adapted a variety of microorganisms: viruses, bacteria, fungi, protozoa, helminths, and arthropods. In the nature of a lot of evidence on the phylogenetic relationships of pathogenic microbes from nonpathogenic to the emergence in the evolution of new pathogenic forms of bacteria under favorable environmental conditions and organisms. Conclusion. Recommended livestock farms are to be regarded as ecosystems, artificially created by man. In them, there are special relationships between animals, protozoa, a diverse microflora, which are fundamentally different from those in vivo. In artificial biocenoses, the Association of conditionally pathogenic microorganisms that circulate in the economy can cause various diseases in farm animals.

The body of calves has high lability, the formation of its resistance and adaptive abilities are most expedient in the early stages of ontogenesis, but if the feeding, care, and maintenance conditions do not meet the requirements of the organism, animals are forced to adapt to these conditions, primarily due to increased energy costs. At the same time, the processes of all links of the metabolism are disturbed and the resistance to diseases decreases. The article presents the classification of antenatal hypotrophy of calves based on the criteria for assessing the state of clinical and zootechnical status and changes in the morphological and biochemical parameters of the blood of sick animals. A method for correcting the energy status of newborn calves with prenatal hypotrophy using carnitine chloride is described. Antenatal malnutrition is the pathology of the fetus, manifested by a violation of its development and arising as a pathophysiological reaction to an inadequate supply of the fetus with oxygen, nutritional and biologically active substances, or in violation of their digestibility. A comparative study of the effectiveness of the correction of metabolic disorders in calves with postnatal hypotrophy with a 10% solution of the transmitochondrial fatty acid transporter carnitine chloride at a dose of 100 mg/kg/day was carried out. The material for the study was the Holstein-Friesian calves from birth to 14 days. All calves were similar in age, body weight and were in the same conditions of housing, feeding, and care. Calves with signs of prenatal malnutrition were divided into 2 groups: experimental and control 6 animals each. The use of a 10% solution of carnitine chloride in hypotrophic calves restores the level of glucose, the main source of energy in the body, and inorganic phosphorus used for various phosphorylation processes to form adenosine triphosphate (ATP), stabilizes anabolic, transport, and catabolic processes, which together alleviate the condition of the newborn's body young with malnutrition. The recommended therapeutic approach leads to the stabilization of the energy-deficient state by optimizing the hemorrhological composition of the blood, the glucose content of the basic energy source in the body, and inorganic phosphorus used for various phosphorylation processes, reducing stress in the anaerobic metabolism system and forming reserve macroergic substrates. The implemented therapeutic measures allow, in the body of calves-hypotrophic, to restore nutritional status.

The resource that grows agricultural products is the soils of this country and will always need to be registered and evaluated. Soil quality assessment is a comparative assessment of soil quality and natural fertility when agricultural crops are at a moderate level. Soil valuation is carried out taking into account the soil properties and characteristics, which in many respects are related to crop yields. The assessment of soil quality takes into account the main properties and natural conditions of soils: genetic origin of soils, mechanical composition, humus content, salinity, erosion, stonyness, gypsum and other natural factors.

This article is about the national music of harmoniously developed generations. The aim is to educate through our heritage. Music, song, study of national heritage, appreciation of values, use of classical literature in reviving national antiquity, customs, traditions, effective use of ghazals, sharia, and analysis and research of classical songs, musical spiritual organization of events

The Indian Telecom Industry has always been a pivotal part in growth and advancement of India. It played an important role in digitization of systems and processes across several economically important sectors. India is currently in terms of subscribers count which currently stand at 1.18 billion. Majority of this are wireless or mobile users. In recent years telecom sector has expanded rapidly and demand for better network connection and speed along with data consumption has increased rapidly. But does this growth really turning into fortune for the telecom companies or not. What are the adverse effects of such high competition in the telecom sector on the fiscalwell-being of the companies? In the context with this,current paper focuses on analysing the financial performance of four companies of telecom trade for the duration of 10 years from 2011-12 to 2019-20. It analyses the fiscal well-being of concerned units on the base of some selected fiscal variables portraying four diverse fiscal parameters that areleverage, liquidity, managerial efficiency andprofitabilityof the concerned units. Current paper also seeks to examine if the financial well-being of diverseunits is comparableamong them or a significant difference exist in between them also.

Acute kidney injury is a common complication of myocardial infarction (MI) and
scarce data were available on the effect of vitamin D3 on heart and kidney functions in MI. In
this study, we investigated the potential protective effect of vitamin D3 on cardiorenal
functions in isoproterenol-induced MI in rats and the possible mechanisms involved. It was
shown that in MI rats, there was a significant increase in serum levels of (creatine kinase
myoglobin binding, lactate dehydrogenase, creatinine, malondialdehyde, interlukin-6 and
tumor necrosis factor alpha) and urine levels of (total protein and albumin), with a significant
decrease in urine creatinine level, creatinine clearance and serum levels of [reduced
glutathione and 1, 25 dihydroxy vitamin D] in comparison with the control rats. On treatment
of rats with vitamin D3 prior to induction of MI, these changes were significantly improved in
comparison with the MI rats. Histopathological and immunohistochemical examinations of
heart and kidney in MI rats reflected the deterioration in their structures with presence of
marked apoptosis which were ameliorated on treatment of rats with vitamin D3 prior to
induction of MI. In conclusion, vitamin D3 has a protective effect on heart and kidney
functions in the rat model of myocardial infarction and this beneficial effect could be related
to its anti-inflammatory, antioxidant and anti-apoptoticactions

The aim of the study was to identify and evaluate abnormalities in the exchange of immunological, macro and microelements, as well as to develop methods for their correction in the treatment of nosocomial pneumonia in children. The microelement composition of the blood of healthy children and patients with out-of-hospital and nosocomial pneumonia was studied by neutron activation analysis. The data obtained show that withnosocomial pneumonia, the violation of the trace element status is more pronounced in comparison with healthy children. The developed 3-step method of treatment with the use of an immunomodulatory drug and vitamin-mineral complex Vitrum kids, based on the basic therapy, improves the healing process and normalizes the microelement status of children.

In spite of developments in breast tumors management therapeutic approaches, relapsing, metastasis and resistant are highly observed among the patients, consequently, reduced overall survival. previously, considerable attention has been placed on the intrinsic subtyping depended in the existence or absence of traditional immunohistochemistry (IHC) markers for example estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-related protein (HER2). However, it is extensively understood that cancers are consisted of heterogeneous populations of cells with a hierarchical organization established by cancer stem cells (CSCs). In breast cancers, this CSCs displaying stem cell characteristics is identified as breast CSCs (BCSCs). This small population display a CD44+/CD24−/low phenotype with high ALDH activity (ALDH+ ), and owns advanced tolerability to chemotherapy, other cancer therapeutic approaches and has the capability of tumor bulk reproduction after reduction of cell populations sensitive to first-line therapy which leads to cancer recurrence. In this review, we present special consideration to BCSCs with future guidelines in the creation of a targeted therapy for this population.

Background and Aim: Post operative bleeding is very common post operative complication seen in extraction cases. Anti coagulant therapies are employed to manage several clinical conditions. Patients those who are already on anti coagulant therapy, can show different patterns of post extraction hemorrhage. Anti coagulant makes blood flow via veins more easily. So, blood will be less likely to make a dangerous blood clot (like thrombosis or embolism). The sole endeavor of present study was to evaluate the correlation of post extraction hemorrhage and anti coagulant therapies in younger population. This study was retrospectively performed to assess the related prevalence also in the studied population. Materials & Methods: Patients case history, follow up case sheet and discharge summaries were explored. Younger age group patients those had undergone single tooth atraumatic extraction for different reasons, were selected for study. Patients who reported to be on anticoagulant therapy for more than one year, were studied in group one. Patients who reported to be on anticoagulant therapy for six to twelve months, were segregated in group two. Patients who reported to be on anticoagulant therapy for less than six months, were studied in group three. Patients not receiving this therapy were served as control group or group four. Post operative bleeding was studied under five categories in each group. These were mild, moderate, severe, uncategorized and no bleeding. Statistical Analysis and Results: Statistical analysis was done by statistical software Statistical Package for the Social Sciences (SPSS). P ≤ 0.05 was considered as statistically significant. Total 84 male and 36 female patients were studied in this study. Therefore, majority of the studied patients were male. In group I, 9 out of 30 patients had no bleeding. However, 8 patients showed severe post operative bleeding. 5 patients showed only mild bleeding. In this group (group I), P value was significant for all five severities of bleeding. In group IV, 23 patients had no post operative bleeding. Nevertheless, only 1 patient showed severe post operative bleeding. Only 1 patient showed mild bleeding. In this group (group IV), P value was significant for patients with no post operative bleeding (0.03). Conclusion: Within the limitations of the study, authors concluded that anti coagulant therapies are significantly affecting post operative bleeding in extraction cases. The relative severity and prevalence of bleeding are also exaggerated by time period of anti coagulant therapy. Patients those who were on anti coagulant therapy for more than one year, showed maximum prevalence and severity of bleeding.

Background: In recent anaesthesia practice, videolaryngoscopy is gradually replacing conventional Macintosh laryngoscopy in adult and paediatric patients particularly in difficult intubation scenario. In this study, we compared McGrath Mac videolaryngoscope and conventional Macintosh laryngoscope for laryngoscopy and endotracheal intubation in cleft lip and palate surgeries.
Aim: To compare and assess the ease of placement of endotracheal tube in cleft lip and palate surgeries using McGrath Mac videolaryngoscope and Macintosh laryngoscope.  Methods: Sixty children less than 5 years of age, belonging to ASA (American Society of Anesthesiologists) I and II category, who were posted for cleft lip and palate repair were included in the study. They were randomly divided into two groups of 30 each. In group I, Macintosh laryngoscope was used for laryngoscopy and endotracheal intubation and in Group II, McGrath Mac videolaryngoscope was used. Parameters like range of visibility of  vocal cords (Cormack Lehane in Group I vs Fremantle score in Group II), requirement of external laryngeal manipulation (ELM), time taken for intubation and haemodynamic changes were assessed.Results: The time taken for endotracheal intubation was significantly higher in Group II (20.10±2.83s in Group I vs 24.57±3.52s in Group II, p<0.001). Requirement of ELM was significantly higher in Group I (24/30 vs 2/30, p < 0.001). The heart rates recorded at 1 min, 3 mins and 5 mins of laryngoscopy were significantly higher in Group I (139.7±12.06, 128.47±9.1, 119.37±8.96 vs 125.90±12.24, 120.00±8.35 and 113.03±9.76 in Group II respectively). Cormack Lehane gradings were comparable in both the groups. Conclusion: Laryngoscopy with McGrath VL significantly prolongs intubation time compared to conventional Macintosh laryngoscope in cleft lip and palate surgeries. The requirement for external laryngeal manipulation was less with McGrath VL and also less tachycardia was observed with McGrath VL than Macintosh laryngoscope.

A new alternative in controlling mosquitos, the arbovirus vectors, has emerged in recent years and commonly called Wolbachia method. Currently, a large trial is still running since 2017 in Indonesia to assess the efficacy of Wolbachiainfected mosquito deployment in reducing dengue incidence in Yogyakarta. Awaiting the trial result before implementing the same method in Bandung, however we could not find any reports on the distribution of natural Wolbachia in urban mosquitos from Indonesia, especially for Culex sp and Aedes sp of Bandung. Therefore, field surveys were conducted at four locations (3 subdistricts) from Bandung City and its surrounding area to screen for the natural mosquito infection status of Wolbachia by PCR and sequencing method. We
found that 83.3% of Bandung-captured Cx. quinquefasciatus were female, and 88.2% of those female were naturally infected with Wolbachia. The infection rate was lower for the male Culex, bringing down the total infection rate of Cx. quinquefasciatus to be around half of the captured mosquitos. However, the results from both female Ae. Aegypti of different locations revealed baffling very weak bands on the agarose gel. As for the infection status of Bandung’s captured Ae. aegypti, it is worth to wait for our further results as well as reports
from other studies. And thus, we opted to keep the inconclusive status of Wolbachia infection in Ae. aegypti from Bandung City

Aim: To studybiofilm production by Pseudomonas aeruginosaon endotracheal tubing in the presence of bacteriophage and sub-inhibitory concentration of imipenem.Methods and Results: A total of 20 clinical isolates of P.aeruginosa obtained from endotracheal samples were taken for this study. Bacteriophages were obtained from sewage samples from sewage water treatment plant. Biofilm assay was performed by modified O’Toole and Kolter method wherein a piece of sterile 0.5cm2 ETTwas incorporated into the microtitre plate wells. Student’s unpaired t test, Kruskal Wallis, ANOVA and HSD Tukey’s test were used to analyse data with SPSS 17.0 software. P value of ˂0.05 was considered statistically significant.Of the 20 isolates, only four (20%) of the isolates were resistant to imipenem. In the presence of bacteriophage, the biofilm production was very less in comparison to biofilm production in the presence of sub-inhibitory concentration of imipenem or in plain broth (p = 0.004). Conclusions: Bacteriophages effectively reduced the biofilm production by P. aeruginosa on catheter tip. Significance and Impact:The present study demonstrates the effectiveness of using bacteriophage as a biofilm reducing agent. Further studies are required to prove the use of bacteriophage coated ETT to curb hospital acquired infections

Mosquitoes even though small in size are the deadliest insects causing millions of deaths every year. Mosquitoes are able to spread variety of diseases, among which common are Malaria, Dengue, ChikunGunya etc.1 More than 3000 different species of mosquitoes are identified in tropical and subtropical regions of the world, but only a few are known to act as vectors of diseases to the human beings.2Aedes Egypti is responsible for many of the mosquito-borne diseases and this species exist in the areas where more than 50% of world’s population lives.

This review article covers the current research areas in oral pathology and reflects the broad range that encompasses the development and application of software in digital histopathology, implementation of biomarkers in pathology, genetics and epigenetics. Molecular pathology, regenerative medicine and immuno therapy, holds the promising and optimistic future of pathology. Oral and maxillofacial pathology is standing at the forefront of the revolution and new diagnostic tools and knowledge are taking pathologists into broader roles of research and correlating diagnoses for clinicians. While we are still using the same method and material that has been using for the past 100years, it’s time to change. Digital technologies could push the field into becoming more efficient and more scalable. Utilizing  high-throughput, automated digital pathology scanners, it is possible to capture an entire glass slide, under bright field or fluorescent conditions, at a magnification comparable to a microscope. Digital slides can be shared over networks using specialized digital pathology software applications. The future of digital pathology could eventually encompass enhancedtranslational research, computer aided diagnosis (CAD) and personalized medicine.

Breast cancer is a malignant neoplasm, an abnormal growth of breast tissue that does not see the surrounding tissue, grows infiltrative and destructive, and can metastasize. Every breast cancer patient experiences side effects from various treatment treatments. This is because the therapy that each patient gets varies and also that cancer sufferers have different genetic backgrounds and different environments. Mastectomy in breast cancer patients can cause many patients to suffer from decreased joint mobility, lymphedema, and limitation in daily activities. These complaints can be overcome with arm exercises. Arm exercises are done to improve circulation and muscle strength and to prevent joint stiffness, preventing lymphedema from occurring. The purpose of this study was to analyze the effect of arm exercises on lymphedema prevention by looking at the value of arm measurements before the intervention and after intervention in the intervention and control groups. The research design was a quasi-experimental study with a total sample size of 32 respondents per group so that the total sample was 64 respondents. The research results were based on the t-test. The independently obtained p=0.001, namely p <0.005, which means that there was a significant effect of the arm measurement value on post-mastectomy breast cancer. It is hoped that this study can be used as education for post-mastectomy patients to improve the lymph flow so that lymph flow obstruction does not occur.

Aim: The aim of the study was to investigate the incidence and configuration of C-shaped root canals in mandibular second molars in North Indian population using clinical and radiographic method and to compare the relative efficacies of these two methods. Methods and Material: 500 patients with mandibular second molar teeth scheduled for root canal treatment over a period of 1.5 years were examined during 2018-2019. C-shaped root
canals were determined by clinical examination using modified Melton's criteria and by radiographic method using Fan’s criteria.
Results: Incidence of C-shaped root canals was found to be 6.80% using clinical method and 5.20% using radiographic method. Females had greater (9.4%) predilection than males (4.69%) clinically. There were only 19 teeth in which presence of C-shaped root canal were confirmed both clinically and radiographically

Background- Early skin-to-skin contact (SSC) after birth is a physiological practice that is internationally recommended and has well documented importance for the baby and for the mother. Objectives – to investigate the impact of early skin-to-skin contact among cesarean section mother on breastfeeding, neonatal adaptation and maternal satisfaction.Material & Method- This quasi-experimental study was conducted in selected nursing homes in West Midnapore, West Bengal. The sample consisted of 80 antenatal mothers with their baby. The tool used was a self-structured questionnaire including rating scale used for data collection. The samples were grouped into experimental groups and control groups with 40 samples in each group. The sampling technique used was the non-probability purposive sampling technique. Among all study samples it was assessed by using t-test or chi-square statistical analysis, and analysis was done by the use of SPSS software version 20 and Microsoft Excel, 2007. It was found that the mean breastfeeding score was 23.4 ± 2.1 and 13.7 ± 2.9 in the experimental and control group. The maternal satisfactions mean score in the experimental and control group was 47.7 ± 3.0 and 30.7 ± 2.4. Results- The study shows that the early skinto- skin contact has significant impact on the breastfeeding status and maternal satisfaction level. Early skin-to-skin contact does not have significant impact on neonatal adaptation.

The main aim of this paper is to know whether the temperature have any impact on the increase of corona virus. Covid-19, this name has brought a drastic change in our day-to-day life. People of Telangana have lived through 10 months of the Covid-19 pandemic and there might be more to come. Till date 2.8lakh official cases of covid-19 have been registered in Telangana and there may be many more which have gone unnoticed. In our busy life, we are neglecting our health and no one is maintaining a proper hygiene. And we have been more addicted to junk foods rather than nutrition, because of this reason covid-19 became a threat to our life. So proper precautions and awareness must be spread among people to avoid spread of virus. Fever, cough, breathing problems etc are the
symptoms of this covid-19. If we neglect these symptoms it leads to a severe problem like pneumonia, kidney failure and eventually leads to death of that person. At this moment we don’t have any vaccine to cure this disease, the only prevention or avoiding corona is to boost our immune system. To overcome this pandemic situation, firstly we need to know the important factors that increases in covid-19 cases. In this paper, machine learning techniques are used to identify how temperature varies with the increase of covid-19. Which means we find how the effect of temperature depends on the number of covid-19 cases in Telangana

Hand scaling is the conventional techniques where hand scalers are being used these hand scalers have advantage over other techniques of scaling by providing increased precision and tactile sensation of the clinician which further results in patient’s better treatment outcomes. Magnification is the advanced equipment used which increase the hand-eye coordination for better results. The aim of this study is to assess the periodontal treatment outcome before and after manual scaling executed by conventional method and surgical operating microscope and to evaluate the ergonomic benefit of the clinician and patient comfort levels in both the groups

During clinical practice in hospital, several evaluation method were adopt to support student achieve their competency. Mini Clinical Evaluation Exercise (MiniCEX) is a Workplace-Based Assessment (WPBA) that requires the examiner to observe the student performing a focused task within 15–20 minutes at the clinic or ward with
compulsory immediate feedback. This study aim to identify the differencies of selfeffficacy after implemention mini-CEX amongmidwifery students. The design of this study was quasi experiment design with control group. This study were consist of 2 group, 32 students were an intervention group and 30 students were control group. The
total sampling applied to get the sample who met with inclusion criteria. General Selfefficacy was applied to measure mean score of self-efficacy. The study found the selfefficacy among both group before implementation mini-CEX were low. However, this study found differences of self-efficacy before and after mini-CEX (11.40). The t-test analyzed shows the mini-CEX was significant effective improving self-efficacy (p value: 0.000). In conclusion the implementation mini-CEX was effective to improve selfefficacy among midwifery student during clinical practice. The Mini-CEXcould be effective assessment method for improving the self-effiacy of students.

New anti UV- reactive dyes (1-4) were synthesized from its structure was confirmed by 1HNMR and IR spectroscopy and their dyeing behavior and ultraviolet (UV) protection on cotton and wool fabrics were investigated. From the study, we can see that the exhaustion value reached over 85%, the T (UVA) and T (UVB) were 3.3% and 3.4%, respectively. The fabric dyed with anti UV- reactive dyes had very good ultraviolet radiation protection. The effects of varying dyeing conditions were investigated. Fabrics dyed with anti-UV dyes were tested for color strength (K/S), rate of fading (ΔE) values. The dyed fabrics also showed very good light fastness and good to excellent washing, rubbing, and perspiration fastness. In this paper our work aiming to reduce the undesirable photodegradation effects of UVR on dyed fabrics by applying these new anti UV- reactive dyes.

Objective :This study aimsto analyzetherelationshipbetween macro and micro nutrientsintakeandbreastfeedingduration on stuntingas well asnon-stunting toddlers. Method: Thestudywasconductedusingthequantitativedescriptivemethodwithacase controldesign. Sixty-eight(68)infant were selected after 224 candidates were screened.Stuntingwas measuredonz-score WHZandanalyzedwithWHO Anthro2005 while nutrientintakewasmeasuredbyRecallform1x24 hours,breastfeeding reports were obtained fromquestionnaire. Furthermore, bodyheight(WHZ)wasmeasuredusing microtoise whileBivariateanalysis was carried out usingChisquaretest.Results: The results showedthat thereisa relationshipbetweenstunting and
energywithp=0.000<α=0.05CI9.905(0.630- 37.911),proteinP=0.000<α=0.05CI9.905(0.630-37.911, andvitaminA,p=0.000 <α=0.05CI3.125(1,724-5,664). In addition, there wasalso acorrelationwithcalciump=0.000<α=0.05 CI6.008(2.045- 17.650),zinc=0.000<α=0.05CI8.727 (2,287- 33,303),andexclusivebreastfeedingp=0.000<α=0.05CI9.905 (0.630-37.911). Conclusion:Based on theresults(pvalue 0.000),there isa significant correlation between energy, protein, vit A, Ca, as well as zincintake and stuntingin underfivechildren.

A modern wave of programming technology has been at the frontline of functional languages, experiencing growing success as well as impact. Hughes published an article entitled 'Why Functional Programming Matters', that has now been one of the most recent references in the field.Safe programming defines the method used by software engineers to include multiple safety mechanism for their system.Secure programming can be broken down into two subgroups to analyse its correlation with software design: access control, secure programme initialization, input validation, cryptography, secure networking, secure random number generation, and anti-tampering. In this paper we provide a review of various functional programming in Haskell for encryption. The inkling of functional programming is to make programming more closely related to mathematics. We describe crucial features and trade-offs that has to be well-thought-out while selecting the right method for secure computation

Background:Acute coronary syndrome (ACS) continues to be a leading cause of morbidity and mortality worldwide. Limited data on galectin-3 and pentraxin-3 are found as biomarkers in the ACS population. The objective of this study was to determine the variables that are most affected by high concentrations of pentraxin-3 (PTX-3) and galectin-3 (GAL-3), and the influence they have on outcomes of all-cause mortality in patients with ACS. Patients & Methods:One hundred and fifty patients with ST elevation myocardial infarction (STEMI) were included with 30 healthy subjects served as controls. Blood samples were drawn beforeprimary percutaneous coronary intervention (PCI) and after 12 and 48 hours. Critical changes in Troponine I as well as in PTX-3, GAL-3, lipid profile, CRP, RBS and cardiac enzymes markers were examined. Results:Highly significant time dependent increase in serum PTX-3 and Gal-3 was observed among acute STEMI patients when compared to controls. Troponin I, PXT-3, and GAL-3 showed high sensitivity and specificity in the prediction of Acute STEMI. Sensitivities of Troponin I, PXT-3, and GAL-3 were 96%, 90% and 94% respectively, while specificities were 85%, 85% and 85% respectively. Moreover, significant increase in Troponin I, LDH, AST, CK-total, CK-MB, CRP, RBS and lipid profile were observed among the acute STEMI patients as compared to controls.

Process with independent increments in the theory of random processes contains concepts and theorems that allow us to build probabilistic models in decision-making problems. The Poisson process plays a crucial role in the construction of models. The article analyzes the Poisson process, which is a stochastic process that models many real-world
phenomena. The author defines the Poisson process and considers some examples of calculating the corresponding values associated with the Poisson process.

INTRODUCTION
Supraspinatus tendinitis or painful arc syndrome occurs in the shoulder. The shoulder joint owes its stability to the rotator cuff muscles which are four small muscles locatedaround theshoulderjointwhichhelpmovement,butimportantlytheirtendonsstabilizetheheadofthe humerus within the joint capsule^[1].One of the most common overuse injuries that occur in the upper limb issupraspinatus tendinitis. Supraspinatus tendinitis is caused by repeated stress or over use injury^[2].Tendinitis andpartialtearsinthesupraspinatustendoncausesa“painfularc“sinceasthepersonelevates hisarmsideways,thetendonbeginstoimpingeundertheacromionthroughthemiddlepartof the arc and this is usually relieved as the arm reaches 180^[3].
Tendinopathy is a common painful condition with reduced functional capacity of the tendon associated with the histopathological findings showing failed healing response ^[4].Overuse or repetitive micro-trauma sustained in overhead position and repetitive motion at work place causes degenerative changes and contributes to supraspinatus tendinitis ^[5].Manual treatment consisted of deep friction massage on the supraspinatus muscle, scapular mobilization, glenohumeral joint mobilization, and proprioceptive neuromuscular facilitation techniques ^[6].

This article we discussed about biochemical changes in blood hemophilia A is a worldwide disorder of the coagulation system. It is a male disease, but women with hemophilia are less common in communities with high levels of kinship. There are steps to achieve an optimum life for patients with hemophilia in developing countries, and awareness of the pattern of death in patients with hemophilia is a prerequisite for any health-care program. Owing to the lack of any data on the pattern of death in patients with hemophilia from developing countries, the current study was done to address common causes of death, and the spectrum of causes of death among individuals with hemophilia A and B.

Based on questionnaires and level of 25(OH)D in 466 children under 1 year factors for rickets was identified. Reliable factors were iron deficiency anemia during pregnancy, toxemia of pregnancy of the mother and the lack of vitamin D during first year of life of a child, lack of outdoor stay (less then 20 minutes per day), frequent colds, not effective traditional prevention of rickets vitamin D.

Background: Human immunodeficiency virus (HIV) a lentivirus that acquired immuno deficiency syndrome (AIDS) in which there is progressive failure of the immune system with life threatening opportunistic infections and cancers. So there is a need to identify and establish relationship between serum albumin level with disease severity in HIV/AIDS patients.
Methods: This is cross sectional study was conducted on 81 HIV/AIDS patients presenting to and registered ART center at Chalmeda Anand Rao Institute of Medical Sciences, Karimnagar, during the period from September 2020 to June 2021. A detailed history, clinical examination and laboratory investigations was done.
Results: Our study the mean serum albumin level was 3.11 + 0.50. There was a significant correlation between serum albumin level with CD4 + counts was 0.627.
Conclusion: Study indicating that albumin could be used as a supplementary marker for immunosuppression in HIV/AIDS patients.

Studies have shown that it is easier for people, who are emotionally capable, to cope with life challenges and therefore they are healthier psychologically. Alexithymia exacerbates vulnerability to physical illness and predisposes to chronic illness. The aim of this study was to determine the role of physical psychotherapy on the quality of life of patients with hypertension with alexithymia. In this clinical trial with a pre-test post-test design, 60 patients with hypertension with alexithymia were purposefully selected from the patients referred to the health centers of Semnan and randomly assigned to the experimental and control groups. The intervention was performed during 1.5 months in the experimental group according to the steps designed in the protocol of physical psychotherapy. Data were collected using the Demographic Questionnaire, Toronto Alexithymia and Quality of Life Questionnaire (WHOQOL-BREF) and analyzed by descriptive, inferential and MANCOVA statistics. In multivariate analysis of covariance, there was a significant difference in the linear composition of alexithymia components and quality of life. Overall, physical psychotherapy has had a significant effect on improving alexithymia, blood pressure and quality of life. Therefore, according to the research findings, it can be said that physical psychotherapy has been effective in improving the quality of life and controlling blood pressure in patients with high blood pressure with alexithymia and performing this treatment in the above patients is recommended as a suitable complementary treatment.

In this paper, we obtain the oremson modified Zagrebindex of Cartesian product, Strong product and Tensor product of graphs. Graph slike path and cycle are considered in this work.
MATHEMATICS Subject Classification: 05C15, 05B20.

This article talks about changes in the format of the Russian-language media in Uzbekistan. During the years of independence, the attitude towards the media has changed radically. From the very beginning, measures were taken to create their legal foundations, in the past years, especially over the past 10 years, large-scale measures were taken to liberalize the media and ensure freedom of thought. First of all, I would like to note the creation of a legislative base that meets international standards and ensures the development of the media.

Background: Pseudomonas aeruginosa (P.aeruginosa) is one of the most commonbacteria capable of forming biofilms which are important in the establishment of P. aeruginosa infections on different host tissues includingpostoperative wounds. P. aeruginosa possesses at least two well-defined, interrelated QS systems, las and rhl that control the production of different virulence factors including biofilm development.Objectives: To determine the antimicrobial susceptibility pattern, biofilm producing ability and the presence of QS lasR gene in isolated P. aeruginosa strains from patients withpost-operative wound infections.Methodology:The study was conducted on Fifty-four clinical isolates of P. aeruginosa from infected postoperative wounds in patients admitted in Zagazig university hospitals, Egypt. Isolates from all patients were tested for antimicrobial susceptibility using
disk diffusion method, in vitro formation of biofilm in microtiter plates containing TryptoneSoya Broth (TSB) medium and detection of QS lasR gene using conventional PCR technique. Results: P. aeruginosa isolates showed high prevalence of resistance against ceftazidimeand aztreonam (74.1%), while they showed the lowest resistance to ceftolozan/tazobactam (7.4%). Biofilm formation was detected in 38 (70.4%) of P. aeruginosa isolates; 14.8%, 46.3% , 9.3% and 29.6% of isolates were strong, moderate, weak and non-biofilm producers, respectively. The lasR gene was detected in 42 (77.8%) of P. aeruginosa isolates. There was significant relation between biofilm formation and presence of lasR gene. Conclusion:Postoperative wound infection may serve as a reservoir for multidrug resistant biofilm forming P. aeruginosa. The QS lasR gene is strongly associated with biofilm formation,which can help in identifying lasR gene as a useful diagnostic marker for biofilm producing P. aeruginosa
strains isolated from infected wounds.

Introduction: Sagittal relation of maxilla to mandible is one of the most important diagnostic criteria in orthodontics. A number of geometric parameters, such as ANB angle, Wits appraisal have been defined and used effectively for the same. Yen angle and W angle has developed recently. It is requisite to evaluate reliability and validity of Yen angle and W angle by comparing them with ANB and Wits appraisal.
Aim: To assess Yen angle and W angle and compare them with ANB angle, Wits appraisal in predicting sagittal jaw dysplasia.
 
Objective:

To compare newly introduced sagittal dysplasia indicator Yen angle  and W angle with ANB angle and wits appraisal in class I malocclusion.
To assess the reliability and validity of the Yen angle, W angle.
 To assess the correlation between these angles with each other in class I malocclusion.

Materials and Methods: Standardized pretreatment lateral cephalograms of 40 subjects with class I molar relation of orthodontic patients were collected and traced and all the four parameters i.e ANB angle , Wits appraisal, Yen angle, W angle were measured and compared. Independent t-test and Pearson’s correlation coefficient were used as statistical analysis.
Result: Statistically significant correlations were found among all the four measures; ANB angle, Wits appraisal, Yen angle, and W angle. Yen angle W angle shows highest correlation with ANB angle.
Conclusion: All the four sagittal indicators show a significant correlation with each other. Yen angle and W angle show highest correlation with ANB angle and least with wits appraisal. Yen angle and W angle can be used as sagittal jaw indicators in addition to the established measures.

: Term Insurance as the name suggests is a Life Insurance policy that is taken for a certain period or term in case of unfortunate death of the policyholder the sum assured is paid to the beneficiary nothing is paid out to the policyholder if he or she survives the policy term which makes term insurance a pure life insurance policy which can give you a very high cover for very low premium as compared to traditional life insurance policies . Due to dynamism and contingency in today’s world ,new products for Term insurance is in demand which have characteristics containing preferences of the customers in this segment. The purpose of this study is to explore the attributes that influence consumers on purchasing a term life insurance plan in India . The conjoint approach is used to analyse the new purchase decision of customer by taking into consideration of different attributes of the product or Plan.  In the study sample is collected from the respondents who identified themselves as insurance decision-makers by taking term insurance . The customers are requested to rate the different profiles of the term life insurance policy included in the questionnaire. The consumer is selected using the Non-probability Judgmental sampling method. The Study concluded that the most important attributes of the Term insurance plan are Brand and payment options. However, the least important attributes of the term insurance plan are found to be sale channel, Term assured, and Rider benefits.
 

Introduction: Non-Hodgkin lymphoma is a type of neoplasm that affects the lymphoreticular system. Even though bone lesions are rare, it does affect the jaws and, more so, the maxilla than the mandible. Around 40% of NHL originate from the extranodal sites (1). Head and neck NHL is the second most common extranodal site after gastrointestinal tract (2). Presentation of case: we present a case of a 58-year-old male patient with complaints of a continually growing mass in the upper left tooth region of a previously extracted tooth fortwo weeks. A CBCT scan was done which showed proliferation of a mass into the maxillary sinus along with the presence of an oro-antral fistula and loss of palatal cortical plate.Histopathological evaluation revealed the NHL of the maxillary sinus. Discussion: The second most common malignant pathology of the head and neck area after squamous cell carcinoma; Lymphoma, presents most commonly as a persistent swelling in the oral cavity. Other symptoms may include pain, paresthesia, foul smell, discoloration. Lytic changes may also be seen in the bone upon radiographic examination.

Treatment of an alveolar defect in a case of cleft lip and palate remains an onerous task to cleft surgeons. Alveolar bone grafting using autogenous bone grafts, has unanimously remained the treatment of choice for closure of alveolar defect in almost all cleft centers around the world. However, this treatment option is far from ideal. The success rate of alveolar bone grafting exponentially decreases with the increase in the size of the defect. Complications like graft resorption, wound dehiscence and recurrence of fistulae make alveolar bone grafting unpredictable for large defects. Management of soft tissues in an alveolar cleft defect poses an equally arduous challenge. Closure of soft tissues under too much tension almost always gives way to wound dehiscence.

BACKGROUND OF THE STUDY: Population in India was not growing rapidly till the early twenties of the last century. It was nearly static, with a relatively safe and acceptable rate of annual growth, since both birth and death rates were relatively high .With advances in technology and expansion of health services death rate started declining in the following decades. Meanwhile the birth rate continued to persist at the same level .This caused a severe demographic gap between the birth and death rate, and resulted in growth of population at an alarming rate. OBJECTIVE: To assess the knowledge and perceived barrier regarding IUCD. METHOD AND MATERIAL: A quantitative research approach with non experimental comparative descriptive study was adopted in this study. The non-probabality, purposive sampling technique was used to select the subject for the study. Data collected from 100 subjects were analyzed by descriptive and inferential statistics.

The development of the Public Health Policies of a country is intended to improve its fellow citizens' health level, so that their planning, management, and evaluation of results depend exclusively on the statistical improvement of problems identified before their elaboration. The decision to apply it is not dependent on any political-party
intervention, as this would interfere with public policies' proper development. This research aims to understand the role of social and political organizations in the formulation of health policies in Bolivia, before and during the pandemic period. For this, semi-structured interviews were conducted with key actors who fulfilled the role of health authorities and informants from social and/or political organizations, also analyzing national journalistic views on the subject. A significant finding was the participation of political party actors related to the blocking of public policies, the creation of parallel associations related to the health sector, which leads to the unfeasibility of the policies as they are related to an electoral purpose, poor management, This has an impact on infrastructure deficits and violation of the labour rights of health personnel. The structural analysis shows that the policies must
be analyzed in the short and medium-term and the aspects related to the Imposition of public policies, the unfeasibility of these and social movements are shown with greater urgency.

This paper represents an analysis of the Geo / G / 1 / K / N system in which the capacity of the service facility is less than N the total quantity of messages in the system. Consider the Geo / G / 1 / K / N system without a server holiday, assuming a late-arrival model with partial acceptance and a belated substitution rule, then a Geo / G / 1 / K /N Consider n systems with multiple servers. The service arrives at the end of each slot with a message probability in the source

Nowadays, there is a continuous and progressive global public exposure to acrylamide (ACR) due its presence in fried and backed food. Thermal preparation of sugar-rich food mostly initiates chemical reactions that yield dangerous chemicals. Of these chemicals arise acrylamide and its metabolite glycidamide. Those having a high
affinity for binding to nervous tissues. The acrylamide-induced neurotoxicity involves reduction in proliferation of neuronal progenitor cells associated with apoptotic cell death. Concerning acrylamide-induced toxicity, preventive medicine research focused on natural antioxidants. Studies on active constituents of Saffron showed obvious antioxidant, and anti-toxic properties. Here, we designed this study to investigate the possible protective
effect of saffron against acrylamide-induced neurotoxicity in hippocampal area of brain. Adult male albino rats were assigned equally into 4 groups (n = 8); control; saffron group; acrylamide (ACR)-administered group and combined ACR and saffron- treated group. Our results recorded molecular changes as a significant decrease on genomic DNA fragmentation in saffron co-administered group as compared to ACR-exposed group. The changes on DNA mutagenicity were studied by analyzing the random amplification of polymorphism of DNA that showed an elevated genomic integrity on rat co -administered saffron with ACR in contrast to those exposed to ACR only.

Psychiatry,addiction and child psychiatry, medical psychology, psychotherapy department The paper presents the results of studies of the clinical and neurological status in patients with vertebrobasilar insufficiency (VBI) with impaired venous circulation in the brain. The obtained results allow concluding that clinical course of the disease in patients with VBI depends not only on basilar and vertebral artery lesions but also, largely, on impaired cerebral venous blood circulation.

Studies have shown that it is easier for people, who are emotionally capable, to cope with life challenges and therefore they are healthier psychologically. Alexithymia exacerbates vulnerability to physical illness and predisposes to chronic illness. The aim of this study was to determine the role of physical psychotherapy on the quality of life of patients with hypertension with alexithymia. In this clinical trial with a pre-test post-test design, 60 patients with hypertension with alexithymia were purposefully selected from the patients referred to the health centers of Semnan and randomly assigned to the experimental and control groups. The intervention was performed during 1.5 months in the experimental group according to the steps designed in the protocol of physical psychotherapy. Data were collected using the Demographic Questionnaire, Toronto Alexithymia and Quality of Life Questionnaire (WHOQOL-BREF) and analyzed by descriptive, inferential and MANCOVA statistics. In multivariate analysis of covariance, there was a significant difference in the linear composition of alexithymia components and quality of life. Overall, physical psychotherapy has had a significant effect on improving alexithymia, blood pressure and quality of life. Therefore, according to the research findings, it can be said that physical psychotherapy hasbeen effective in improving the quality of life and controlling blood pressure in patients with high blood pressure with alexithymia and performing this treatment in the above patients is recommended as a suitable complementary treatment.

Angiogenesis is a key process in cancerous tumors development. It is regulated by angiogenesis factors. Although in any type of cancer it involves the formation of new blood vessels, there are some differences between cancer types. Angiogenesis is also crucial in brain tumors development. Angiogenesis inhibitors are used in neuroncological treatment. We present an overview of the knowledge of angiogenesis in the two main types of primary brain tumors: gliomas and meningiomas. We hope that the current state of this knowledge is important in the topic of brain tumors pathology and therapy.
 

The interest shown by scientists around the world to human heredity is not accidental. Currently, about 2000 hereditary diseases and genetically determined syndromes are known. Their number is constantly growing, dozens of new forms of hereditary pathology are described every year. At the present stage of development of medicine, recognition of various hereditary diseases and genetically determined syndromes is of exceptional importance.The lack of a generally accepted classification of hereditary diseases, their large polymorphism and the large number of phenocopies create difficulties in the diagnosis and differential diagnosis of heredial forms of pathology.

One of the most frequent pathologies in the practice of a traumatologist-orthopedist is damage to the ankle joint, accounting for up to 20 % of injuries to the musculoskeletal system. The frequency of ankle ligament injuries among people of working age ranges from 12% to 40%, severe ankle fractures with damage to the deltoid ligament and rupture of the distal intertibial syndesmosis in 30% of cases result in unsatisfactory results [1]. According to statistics, the occurrence of ankle fractures is on average 100-120 cases per 200 thousand. population per year. From 54.1 to 84.6% of ankle fractures with a rupture of the MBS occur in young and able-bodied people [1-3].

Currently, dysplastic coxarthrosis firmly occupies the second place in the structure of degenerative-dystrophic diseases of the hip joint[1,3]. The incidence of pathology accordingv to various data ranges from 25 % to 77 %. Dysplastic coxarthrosis (DCA) is one of the most severe consequences of hip diseases such as dysplasia, congenital hip dislocation, Legg-Calve- Perthes disease, coxa-vara, etc. According to the literature, degenerative processes in the hip joints lead to a decrease in the working capacity of patients in 60-70% of cases, and to their disability-in 11-38%, and these indicators have acquired a steady upward trend in recent years [4,5].

Purpose: To study indicators of central and peripheral hemodynamics in pregnant women with obesity of varying severity at a gestational age of 36-38 weeks.
Materials and Methods: To study hemodynamic parameters (heart rate, SDD, UI, SI, OPSS, CR, LVMI) in pregnant women with obesity of varying severity, 127 pregnant women (I, main group) aged from 23 to 34 years were selected obesity of varying severity with gestational age 36-38 weeks. The second (control) group consisted of 28 pregnant women of the same age and gestational age with normal body weight (body mass index from 19 to 24.9 kg / m2). The groups were identical in age, gestational age, which allowed for an objective and comparative assessment.

The brain tumor segmentation acts as a major task in the field of medical image processing. The detection of cancer in manual manner with the large MR images is very tedious, as it requires more time. Thus, in order to overcome the drawbacks of the manual segmentation of the brain tumor, automatic brain tumor segmentation is needed. This paper presents an automatic segmentation of brain tumor using Contourlet transform and Chan-Vese active contour model. The Contourlet transform captures edges and smooth contour at any orientation and it also filters the noise in image in a better way. The Contourlet transform with its extra feature of directionality gives images of high resolution. Chan-Vese active contour models are region based segmentation models and they use optimal piecewise smooth approximation function for the segmentation. These models are very accurate as compared to the traditional segmentation techniques.
 

Introduction: Women with RA have higher grades of disease activity and more declines in health status than men with RA; this recommends a relationship between estrogen and disease activity and severity.
Aim: Our aim was to detect the effect of sex hormone fluctuations and menopause on functional disability and quality of life of postmenopausal RA patients.

Background: Acne vulgaris is a chronic inflammatory disorder of the pilosebaceous unit that is associated with significant psychosocial repercussions. Chemical peeling is a documented option in the treatment of active acne. Glycolic acid belongs to the group of α-hydroxy acids is used as a superficial or medium depth peel in acne treatment Jessner’s solution (JS) peel is formulated by Dr. Max Jessner to minimize complication from resorcinol, namely contact
dermatitis. Salicylic acid also decreases in inflammatory lesions

Background: Proper management of the urinary bladder cancer depends on the stage of the lesions. The aim of this work was to correlate between the outcomes of DW-MRI results and biopsy results of 2nd look TURBT in NMIBC and to correlate between DW-MRI and conventional MRI in NMIBC. Patients and methods: It was a prospective study included twenty four patients with NMIBC underwent 2nd look TURBT with preoperative imaging with DW-MRI on pelvis. Bladder mapping was done on 1.5 T Philips Achieva system class II MRI device is used. T1andT2 weighted is used for anatomical and morphological evaluation. Diffusion-weighted images were obtained by using single shot echoplanar imaging with a pair of rectangular gradient pulses along three orthogonal axes. Second look cystoscopy and biopsy was performed under spinal anesthesia. Resection of lateral wall bladder tumors was performed under general anesthetic with a paralytic agent to avoid inadvertent bladder wall perforation from an obturator nerve reflex .Biopsy was taken from the tumor base or residual of the mass if present for histopathological examination Results: Sensitivity of DW-MRI was 100%, specificity was 92.8% and accuracy was 96.8% in prediction of malignancy, while Sensitivity of DW-MRI was 83.33%, specificity was 80% and accuracy was 81.25% in prediction of muscle invasion tumors. 14 of the 32 lesions analyzed in the second TURB were diagnosed as MIBC. There was a significant correlation between clinical staging by DW-MRI and pathological staging Conclusion: This study show the superiority of DWMRI to T1W- and T2WMRI in differentiating residual bladder cancer from postoperative changes after an initial TURB. DW-MRI showed reasonable high sensitivity, specificity, accuracy and agreement compared to the results of the gold standard pathological examination of urinary bladder tumors. DW-MRI can be a useful adjunct for optimal selection of patients for a second TURB. It can replace the diagnostic part of second look cystoscopy

Background: Prostate cancer is most frequently diagnosed cancer of men and bone is the most common site of metastasis. There is a lack of consensus for the selection criteria for bone scan in low-risk patients. Serum prostate-specific antigen (PSA), which is produced by all types of prostate tissue, is one of the most important biomarkers for detecting prostate cancer, guiding decisions about biopsies of the prostate and offering a way to monitor disease progression. Objective: The aim of this study is to correlate between PSA levels at the time of diagnosis, aggressiveness (Gleason score > 7) and bone metastasis of histologically proved prostate cancer patients. Patients and methods: This study was a Cross Sectional retrospective study collected from medical records at cancer registry archive of Clinical Oncology and Nuclear Medicine at Zagazig University Hospital from January 2014 till January 2019 on 86 prostatic cancer patients with bone metastasis Results: Mean PSA was 217.11±92.56 with range of (100.2 – 502.3), <10 was present in 8.1% of cases, 10-20 was present in 19.8%, 20-100 was present in 34.9% and >100 was present in 37.2% of cases. There was significant relation between PSA and orchidectomy (p<0.001), there was high significant relation between bone metastasis, PSA level (p<0.001) and type of PSA level (p<0.001) and there was significant positive correlation between PSA and GS score, bone metastasis, orchidectomy and ADT. Conclusion: There was strong association between the PSA level, tumor aggressiveness 9 Gleason score), and bone metastasis has been identified in patients already diagnosed as cancer prostate.

Background: Calprotectin was identified as an endogenous Toll-liken receptor 4 (TLR4) activator and as a receptor for progressive glycation end products (RAGE), Elevated Calprotectin plasma levels have been recorded in various chronic inflammatory conditions, expecting microvascular alterations in patients with type 2 diabetes (T2DM). Objective: To make an up to date review of Serum level of Calprotectin as a predictor for early diagnosis of peripheral neuropathy in type 2 diabetes patients. Patients and methods: A total number of 90 subjects were included in the study after fulfillment of the inclusion and exclusion criteria. Calprotectin was measured for all the 90 subjects. Results: Serum calprotectin levels were significantly higher in group III “diabetics with neuropathy” compared to group II “diabetics without neuropathy “and group I “healthy controls” Conclusion: In Type 2 diabetes patients with peripheral neuropathy, elevated levels of calprotectin have been identified.

Background: pain after Cesarean delivery (CD) can negatively affect ambulation, breastfeeding, and maternal bonding. The aim of this study was to determine whether a correctly performed TAPB can provide better control of acute postoperative pain during the first 48 hours after CS and if it can provide a faster postoperative recovery.
Patients and methods: included 32 participants who underwent elective caesarean section assigned randomly into two groups. Group A: 16 patients received TAP block. Group B: 16 patients did not receive any block. Medicine Ten centimeters visual analog scale (VAS) was also explained during preoperative visit. The postoperative pain was evaluated at 1, 2, 4, 8, 12, 18 and 24 hours by using VAS for pain scoring that was explained to the patients
during preoperative visit as a 100 millimeter horizontal line with verbal anchors at both ends. Results: Our study showed that there is statistically significant difference between the studied groups regarding VAS pain scorebaseline or at any point of time (significantly lower in TAP block group). In each group, there is significant change (increase) in VAS pain score over time. There is statistically significant difference between the studied groups regarding time for first analgesia (significantly longer in TAP block group). Number of patients who need nalufin was significantly higher in control group (ten patients within control group versus only one in TAP block group). Also, there is statistically significant difference between the studied groups regarding patient satisfaction. More than half of patients (56.2%) within TAP block group were very satisfied while half of those within
control group felt neutral (neither satisfied or not). Conclusion: Transverse abdominis plane block represents a viable alternative to common analgesic procedures performed for acute postoperative pain control after a CS.

Aim- To test the reliability of three different alternative points to point A in class II division 1 and division 2 malocclusion.
Material and method- The study was conducted on 120 Left lateral cephalogram on the basis of ability to locate point A with considerable degree of accuracy.The sample was divided into two groups:Group 1 consisted of 60 class 2 division 1 lateral cephalogram and group 2 consisted of 60 class 2 div 2 lateral cephalogram.Three alternative methods for point A estimation were evaluated for reliability in vertical and horizontal planes.
Results and Discussion- Point A2 was the most accurate in both the vertical and horizontal planes and both A2 and A3 can be used in the vertical plane as an alternative to Point A.
Conclusion- Point A2 is the best reliable substitute to point A and A3 being the least dependable in both the groups for assessment of sagittal jaw relationship.

Background: Anemia is a common complication in Chronic kidney disease (CKD) patients. It has a multi-factorial pathogenesis. Replenishing iron stores and giving ESAs are the main lines of treatment. There is a general agreement on the optimal route for iron supplementation in ESRD patients with the IV route but there is no such agreement on the optimal route for iron supplementation in pre-dialysis CKD patients. Erythropoiesis stimulating agents (ESAs) treatment represent an economic burden and has been linked to possible cardiovascular side effects. This study amid to assessing the efficacy of erythropoietin in treatment of anemia in CKD patients. Methods: A prospective cohort study was conducted in chronic kidney disease patients who had undergone hemodialysis in Met-Ghamr hospital of nephrology from February 2019 to July 2019. Included 50 patients on maintenance hemodialysis, we tested the efficacy through comparing the efficacy low fixed ESA dose (4000 IU IV once weekly) versus high fixed dose (4000 IU IV three times weekly). We divided group into two groups, group A and group B. group A were put on a fixed dose of 4000 IU Epoetin alfa once weekly and group B were put on a fixed dose of 4000 IU Epoetin alfa three times weekly. Results: After 6 months, We found a significant difference in hemoglobin response of the two subgroups in favor of subgroup IID (P = 0.004). Conclusion: That low dose ESAs is less effective in correction of anemia in dialysis patients than high dose ESAs.

Background: Acne vulgaris is a chronic inflammatory disease of the pilosebaceous unit. Ductal hyperkeratinization, increased secretion of sebum, and colonization of Propionibacterium Acnes (P. acnes) around the pilosebaceous gland are among the factors responsible for the etiopathogenesis of acne vulgaris. Interleukin- (IL-) 19 is a cytokine expressed by epithelial cells with proinflammatory stimulation. A distinctive feature of IL- 19 is their ability of giving positive feedback loop to amplify themselves; once they are activated in inflammatory process, they will continuously produce the cytokine. The study aimed to identify the relation between blood levels of IL-19 and acne vulgaris. Methods: 36 acne patients and 12 healthy subjects were included in our study. All of patients and controls were subjected to full history, full general and dermatological examination. Serum IL-19 level was measured from each subject using quantitative sandwich enzyme-linked immunosorbent assay (ELISA) serum kits. Results: There was no statistical significance difference between the cases and controls in age and sex.Serum Interleukin 19 level is highly significant increased in patients with acne compared to controls. Serum IL-19 level was statistically significant with age of patients, disease duration and site of lesion. Conclusion: Interleukin 19 is higher in acne compared to controls. level of IL-19 positively correlated with age of patients and disease duration, that was statistically significant

Background: Musculoskeletal pain (MSP) is a major cause of chronic pain, injury, illness, reduced educational attainment that may affect the quality of productivity, neck pain (NP) is a common condition affecting as much as two-thirds or more of the general population,low back pain (LBP) is social and economic health problem that affects population of all ages globally. Objective: To assess prevalence and associated risk factors of neck and low back pains among students at Faculty of Medicine, Zagazig University. Patients and methods: This study was a cross sectional study conducted on 382 students at Faculty of medicine, Zagazig University. From September, 2018 to April, 2019, they completed the questionnaires (self-administrated or online questionnaire) in the English
language. Results: The prevalence of neck pain and/or low back pain among the studied group of students was 81.1%. NP presented in 74.4% while LBP detected in 73.1% of all studied students where 66.4% of participants reported both NP & LBP, the significant predictors of NP & LBP were studying more than 6 h/d, ergonomic problems and poor psychological studying environment (p<0.005, <0.005, <0.001 respectively). Conclusion: This study demonstrated high prevalence of NP &/ or LBP 81.1% among medical students at Faculty of medicine, Zagazig University, Students complaining from NP and/or LBP had longer studying and reading time, presented mostly in clinical years in addition they had ergonomic problems and poor psychological studying environments

Autophagy is a catabolic process that targets impaired organelles and proteins for lysosomal degradation to maintain cell hemostasis. Autophagy in cancer is dynamic and, more specifically, depending on the stage and type of tumor. Researches in genetically engineered mouse models are agreed with the concept that autophagy can constrain initiation of the tumor by controlling oxidative stress and DNA damage, while in established tumors, autophagy can also be required for tumor survival. As shown in preclinical models, suppression of autophagy restored chemotherapy sensitivity against tumor cells. Targeting autophagy in cancer will develop a new era for anti-cancer drugs, but more specific and potent inhibitors of autophagy are needed. The role of autophagy in cancer cells continues to emerge, and further studying to identify optimum strategies to modulate autophagy for therapeutic advantage. 

Progressive multifocal leukoencephalopathy (PML) is a rare and severedemyelinating diseasewhich occurs in immunocompromised patients. A 51-year-old male presented to us with a difficulty in walking and loss of sensation on left side, he was provisionally diagnosed to be a case of cerebrovascular accident. His serology tests came as positive for HIV. Further work up with imaging as well as laboratory testing was done and he was proved to be a case of progressive multifocal leukoencephalopathy which is rarely reported in Indian literature. Our patient unfortunately passed away after 3 days. This case is a reminder that one should keep an open mind for multiple as well as rare possibilities while dealing with a patient of neurological deficit.

Diabetes can be turn into life threaten diseases, if it is not treated at an early stage. Especially, in the women, the chances of diabetes is higher as compared to men due to the hormonal changes during pregnancies. Due to this, they suffer a long term diabetes as well as other diseases due to their tensions and regular life chores. This can be prevented if the diagnosis is determined at an early stage. Mostly, the trained doctors are required to confirm the diabetes. It requires manual work and complete knowledge in it. This problem is avoided by several research works using machine learning algorithm for the classification. Those algorithms process effectively for smaller dataset with smaller number of attributes. Hence, to overcome this shortcomings, in this an optimization based classifier is proposed to process on larger datasets like BIG DATA. In existing, the improved K-means and logistic regression algorithm is applied. It able to improve the classification rate but the features for training and computational time is high. To overcome this problem, an optimization based machine learning approach is used in this paper. Before the classification process, the data is pre-processed to remove the missing values and non-available values. In this, the K-means clustering is applied to the data to remove the outlier data and to reduce the training time period of the prediction process. The prediction of diabetic is done with the help of feed forward neural network. The inputs for the network is by selecting dominant attributes in the dataset using optimization process.  The objective function is to reduce the misclassification rate of the classifier. In this, the cuckoo search optimization and feed forward neural network is used. This approach able to improve the accuracy as compared to the existing technique. The whole process is realized in MATLAB R 2018a environment and evaluated in terms of accuracy, precision, recall, F-measure and Matthew correlation coefficient.This approach outperforms all other existing technique with F-measure of 96.7%.

Data streams mining on transactional data is very attractive area for researcher, identical about transactional data makes compromise the privacy of individual so identical information must be removed from transactional data. For publish static transactional streams many privacy- preserving techniques proposed ,these methods are not straightforwardly applied on transactional data streams because it have different characteristics .in sliding window addition and removal of transaction leads be unsuccessful to satisfy ρ-uncertainty . to maintain ρ-uncertainty remove the items of window, due this heavy information loss we proposed algorithm which dynamicallyselect items for remove to maintain satisfy ρ- uncertainty with less information loss and continuously make satisfy p-uncertainty of slide window with suppression of anonymize sliding window , experimental shows our method is more efficient than batch existing batch processing anonymization sliding window methods

Background: Various techniques have been used for securing the appendicular stump, some of which is expensive as endoscopic linear cutting stapler (7,8); others are not available in some hospitals as preformed suture loops (endoloops).We raise the question of safety and effectiveness of securing the appendicular stump by clipping versus intra-corporeal ligation in laparoscopic appendectomy to patients with acute appendicitis.
Aim: We compare between clipping versus intra-corporeal ligation of appendiceal stump regarding safety, timing of operation and difficulty.
Patients and Methods: Forty patients presented with acute appendicitis at Damanhour Teaching Hospitaland Theodor Bilhariz Research Institute (TBRI), the diagnosis was based on clinical diagnosis,laboratory and ultrasonographic findings. They were divided randomly into two groups: Group I: Metal Clip group (MC Group), and Group II: Intra-corporeal ligation group (ICL Group).
Results: There was no statistically significant difference between patients of both groups as regarding age or gender while group II were significantly higher in operative duration. Group I is higher in the rate of conversion to open and post-operative complications. there have been no statistically significant differences regarding hospital stay.
Conclusion: The two techniques of clip application and ligature are effective in securing the appendicular stump in laparoscopic appendectomy. With increasing the skills of ligation we prefer ligation over clipping especially with large, hard and friable appendiceal stump.
 

Background: Diabetes mellitus and hypertension are interrelated diseases sharing common
etiology and disease mechanisms that predispose to cardiovascular disease. Hypertension is
approximately twice frequent in diabetic patients compared by non-diabetics.
Aim: This study was designed to compare the potential cardiovascular beneficial effects and
pancreatic β-cell function improvement by vildagliptin as DPP-4 inhibitor and canagliflozin as
SGLT2 inhibitor on diabetic hypertensive male albino rats.
Materials and Methods: thirty-six rats were randomly divided into 4 equal groups: Control group,
Diabetic hypertensive, Vildagliptin-treated diabetic hypertensive (20 mg/kg/day by orally) and
Canagliflozin-treated diabetic hypertensive groups (40 mg/kg/day orally). T2DM was induced by
I.P. injection of nicotinamide (230 mg/kg) 15 min prior to single dose injection of streptozotocin
(60 mg/kg, IP). Hypertension was induced by L-NAME (50 mg/kg, PO) for 4 weeks. The assessed
parameters were systolic and diastolic blood pressure (SBP and DBP), fasting blood glucose
(FBG), serum endothelial nitric oxide synthase (eNOS), proinsulin, insulin, proinsulin/Insulin
ratio, relative expression of MafA gene (β-cells specific transcription factor), Pancreatic and
duodenal homebox-1 (PDX-1) gene, and histopathology for pancreas.
Results: The results of the present study demonstrated that oral administration of vildagliptin
orally for 4 weeks for diabetic hypertensive rats produced beneficial cardiovascular effects as
evidenced by the significant reduction of SBP and DBP and the significant increase in serum
eNOS level. Moreover, vildagliptin improved pancreatic β-cell function evidenced by the
significant reduction of the proinsulin/insulin ratio, the significant increase of MafA and PDX-1
gene expression and the improvement of the histopathological picture of the pancreas.On the other
hand, the results of the present study showed that oral administration of canagliflozin orally for 4
weeks for diabetic hypertensive rats produced significant reduction of SBP, but there is
insignificant change of DBP and serum eNOS level. Also, it was found that oral administration of
canagliflozin significantly increased insulin and proinsul in with no significant change of
proinsulin/insulin ratio. In addition, canagliflozin improved pancreatic β-cell function evidenced
by the significant increase of MafA and PDX-1 gene expression and the improvement of the
histopathological picture of the pancreas; however, vildagliptin has better effects on these
pancreatic β-cell parameters.

Herein, we report the unique property of MOF as a photo catalyst: ferrocene (Fc) based Co-MOF (probe R1) prepared by a simple method was able to react with H₂O₂ to achieve high efficiency in photocatalytic Fenton process. In selective heterogeneous Fenton process using Fc based Co-MOF; the results suggest that the combination of Fe²⁺/Fe³⁺ cation and H₂O₂ can significantly improve the photocatalytic proficiency at room temperature.  It could completely remove MO azo dye in the presence of a certain amount of H₂O₂ under visible light within 40 minutes. The activity performed by varying different parameters, such as dye and catalyst concentration, pH, H₂O₂ dosage. MOF catalyst shows better adsorption at acidic medium. When the quantity of photo catalyst R1 increased, then the decolorization of the azo dyes enhanced. The degradation diminishes with increasing the concentration of dyes as well as pH range. This work reveals that Fc based Co-MOF materials hold countless potential for assertions in the field of radiation-energy exchange into chemical energy. The photo catalyst probe-R1 perceived that was a perfect photo catalyst from the degradation/adsorption of Methyl Orange in the presence of visible radiation.
Keywords- Degradation, Fenton Catalyst, H₂O₂, MOF, Visible light.

Background: Tendons are dense connective tissues composed primarily of a highly
organized type I collagen extracellular matrix (ECM). Which enables a tendon to perform its
mechanical function of force transfer. Platelet rich plasma (PRP) serves as a growth factor
agonist and has both mitogenic and chemotactic properties.
Aim: investigation the effect of PRP in tendon healing in rats, and evaluation the rate of
possible complications.
Materials and Methods: The study included (35) rats, (5) rats only used as donors for PRP,
while (30) rats separated as PRP group:(1); injection, group (2); spray, group (3); mixed.
The left leg in all rats (control group) receives nothing, while the right leg receives PRP as
separated groups. Each rat was kept in a separated cage and checked on until the end of the
follow up period (15-30) day. After (15) and (30) days post-treatment, (5) rats of each group
were sacrificed, and their Achilles tendons were extracted and examined histopathologically.
Stained sections examined for the number of the inflammatory cells / HPF,
the ratio between collagen 1 and collagen 3 and the arrangement of the collagen fibers

Background: CHA2DS2VASc score is a predictive tool that enables estimation the risk of
developing ischemic stroke and thrombo-embolism in cardiac patient. Intracoronary thrombus
formation due to atherosclerotic plaque rupture and the interruption of coronary blood flow
constitute the main pathophysiology underlying acute coronary syndrome Objective:
Assessment of the ability of CHA2DS2-VASc score for predicting high intracoronary thrombus
and to evaluate the prognostic value of it in assessment of stroke, re-infarction and mortality in
patients with Non- ST-Elevation Myocardial Infarction (NSTEMI). Methods: Sixty-six patients
were enrolled in our study, divided into 2 groups; Group I (n = 33 patients) represents low
thrombus grade, Group II (n = 33 patients) represents high thrombus grade. All patients were
subjected to coronary angiography to assess degree of stenosis and coronary flow by
thrombolysis in myocardial infarction (TIMI) grade score. Sensitivity, specificity and diagnostic
accuracy of CHA2DS2-VASc in prediction of high thrombus burden were assessed. Results:
The mean age for Group I and II was 62.21±9.51 and 66.67±9.14 years respectively. LV
average global systolic strain (AGS) was significantly lower in group I and II when compared to
group III. Age, Killip class and LA diameters are highly significant predictors for incidence of
high CHA2DS2-VASc. The diagnostic accuracy of CHA2DS2-VASc in prediction of high
thrombus burden was 83.3% with cut-off value 4. Conclusion: CHA2DS2-VASc score is a good
predictor of intracoronary thrombus burden in non ST segment elevation myocardial infarction
patients undergoing primary PCI at a cutoff

Objectives: To assess the quality of INR control in Egyptian patients who are on warfarin
therapy through calculating the TTR and study different variables affecting INR control in
those patients. Methods: A Retrospective cohort study conducted in Cardiology Department,
Zagazig University Hospitals, from December 2018 to August 2019. It included 250 patients
who were prescribed Warfarin therapy for different indications. Results: After calculating
TTR of each patient the level of anticoagulation control was determined using the
following cut off values: a) Good control: TTR>70%, b) Intermediate control: TTR 50 -70
%, c) Poor control: TTR <50%. Majority of patients 62% had poor control with TTR less
than 50% and 17.20% had Intermediate control with TTR 50-70%. Patients with good TTR
control represented 20.8%. Conclusion: Majority of Egyptian patients have poor
anticoagulation control by means of TTR. Male gender, higher education and employment
status are associated with higher mean TTR and better anticoagulation control. Male
gender and employment were significant predictors for good INR control.

Background: Postoperative atrial fibrillation (POAF) is a common and potentially morbid
complication following cardiac surgery. It was reported to be associated with greater inhospital
mortality; prolonged hospital stays. In addition, the long-term survival was worse in
patients who developed POAF. Patients who develop POAF incur additional hospital
treatment cost and 2-to-4-fold increased risk of major adverse cardiac events.
Objective: To determine the possible predictors of POAF after coronary artery bypass
surgery and its impact on outcome.
Methods: Two hundred patients were enrolled; they were divided into 2 groups; Group I (n =
100 patients) developed POAF and group II (n = 100 patients) did not developed POAF. All
patients were subjected to history, examination, ECG, echocardiography, laboratory
investigation as CBC, coagulation profile, kidney function tests, liver enzymes and high
sensitivity troponin and coronary angiography to assess severity of coronary artery disease by
SYNTAX score.
Results: POAF score which contain 9 variables: Age >60 y, Smoking, COPD, CP bypass time
(min) >86.5, Vent. Time <23.5, PLR >113.4, LVEF <53.5, RV function by TAPSE <2.15 and
Syntax score >34.5. Each variable takes points according to multivariate analysis with total
score 20. ROC curve analysis was done to pick up the best cut off value of POAF Score and
incidence of POAF which revealed POAF Score more than 10 has sensitivity 99 % and
specificity 86% Area under the curve 0.99. Conclusion: POAF after CABG is associated with
higher morbidity and mortality, prolonged recumbence in the hospital. Prediction of POAF
might be useful in detection of patients at risk for these complications using POAF risk
score.

Background: Acute coronary syndrome (ACS) refers to a spectrum of clinical
presentations ranging from those for ST-segment elevation myocardial infarction
(STEMI) to presentations found in non–ST-segment elevation myocardial infarction
(NSTEMI) or in unstable angina. Contrast-induced nephropathy (CIN) is defined as the
impairment of renal function-measured as either a 25% increase in serum creatinine
(SCr) from baseline or a 0.5 mg/dL (44 μmol/L) increase in absolute SCr value—within
48-72 hours after intravenous contrast administration.
Objective: To evaluate blood urea nitrogen to left ventricular ejection ratio and TIMI risk
index as predictors for occurrence of CIN in patients with acute coronary syndrome who
underwent PCI.

Fluidized bed reactor is useful for heterogeneous (multiphase) reactions, separations, size enlargement, coating, and blending in chemical and pharmaceuticals industries. To develop a model and simulation of this reactor with advanced systems process engineering software (Aspen Plus). Aspen plus has the capability to simulate real factory performance, design improved plants, and intensify profitability in present plants. Thismodeling and simulation are applied Geldart B particle classification, GGC is used for particle size distribution function, Newton parameters for mass convergence, and Ergun equation is used for minimum fluidization velocity calculation and pressure drop through the fluidized bed reactor. Generally, most of the predictions model from Aspen plus is a reasonable agreement through the experimental results. Advantage of this investigationis used small quantity of bed particlesand identified their melting point temperature is above 340°C. This fluidized bed reactor model and simulation is functional for aluminum hydroxide decomposition reaction. The feed 275 kg/hr of Al(OH)3is converted into 169.6 kg/hr of aluminum oxide (Al2O3) and 89.9 kg/hr of water. A total mass conversion percent is 94.4% of aluminum hydroxide.

Background:Despite recent advances in interventional equipment and techniques, the angiographic no-reflow and slow flow phenomenons occurs in a considerable number of patients undergoing primary percutaneous coronary intervention (PCI). We investigated the clinical, electrocardiographic, pre procedural finding that could predict slow flow/ no reflow in ST-segment Elevation Myocardial Infarction (STEMI) patients treated with PCI, also to detect predictors and impact of slow flow/ no reflow during hospital stay and short term outcome of such patients Aim: To identify the clinical, electrocardiographic, pre procedural finding that could predict slow flow/ no reflow in STEMI patients treated with PCI and to determine predictors of adverse clinical events during hospital stay and short term in slow flow /no reflow group. Patients and Methods: Thestudy included 72 patients who were divided into 2 groups, group I with slow flow/no reflow and group II with normal flow. All of them were subjected to follow up for 3months after PCI.

Speed breeding has revolutionized whole of the world in today’s era. The first ever speed breeding procedure was developed through an inspiration from NASA which was adopted by the University of Queensland scientists. Speed breeding is a protocol which enables plant breeders to enhance the crop production changing the temperature and light duration and intensity to enhance the growth of the plant. It is using artificial source of light that too continuously which triggersthe photosynthesis process results in the growth and the process of reproduction comes very early as compared to normal timing. The researches show that by Speed breeding techniques we can grow approximately 6 generations of wheat, chickpea & barley and around 4 generations of canola plants in a single year. This will help us to meet the demands of the growing population of future. This can be accomplished through various technologies such as genotyping, MAS, highthroughput phenotyping; gene editing, genomic selection ,re-domestication which can be integrated with speed breeding to enable plant breeders to keep up with a evolving climate and ever-increasing human population.

Background: The most prevalent form of inflammatory arthritis is rheumatoid arthritis (RA) and it usually involves elbows, feet, wrists, knees, and ankles. The foot is the first region of the body to display RA signs and symptoms for certain patients. This research aimed to assess the prevalence of foot disorders in RA patients, identifying the relationship between the activity of the RA disease and foot disorders, as well as their effect and deformities occurrence.
Patients and methods: A total of 300 RA patients were included in this report. There were 240 women and 60 men, aged between 18 and 74. The following were done to all patients: complete historical review, complete clinical examination, and the evaluation of disease occurrence Complete blood count (CBC), Erythrocyte sedimentation rate (ESR), c-reactive protein (CRP), rheumatoid factor (RF) titer, and anti-cyclic citrullinated peptide (anti-CCP Ab) titer were used and X Ray on foot done to all patients
Results: We found that 31.6% of the study patients had foot deformities. 214 patients (71.3%) had normal gait while 86 patients (28.7.0%) had pathological gait. Hallux valgus was common among old age and obese RA patients. The foot deformities are associated with moderate and high DAS28 activity. Obese RA patients are more susceptible to have foot problems 2.89 times more than normal-weight RA patients. 176 patients (58.6%) had narrowing, 97 patients (32.33%) had osteoporosis 87 patients (29.0%) had erosion, 20 patients (6.67%) had bone cyst, 17 patients (5.6%) had subluxation and 14 patients (4.6%) had amalgamation.

Background: Lupus nephritis (LN) is a serious manifestation of systemic lupus erythematosus. Induction immunosuppression can include high dose cyclophosphamide (NIH protocol), low dose cyclophosphamide (Euro-lupus protocol) or mycophenolate mofetil (MMF). We aimed to assess the efficacy and safety of the 3 induction regimens in
Egyptian patients with LN.

Dentist are more prone for acquiring or transmitting infectious disease during different dental procedures. Chances of cross contamination from patient to patient is also there. This study was aimed to determine the efficacy of two disinfectants. The samples from 30 complete denture patients were obtained. The bacterial colony count was calculated. The study concluded that Sodium hypochlorite was more effective in disinfecting dentures.
Key Words: Denture, Disinfection, Denture base, acrylic resin.

Duration of orthodontic treatment is a crucial parameter from patient as well as orthodontist point of view. Considering this aspect in mind accelerated orthodontic came into existence. The purpose of this split mouth study was to evaluate effectiveness of piezocision-based flapless corticotomy. 50 orthodontic patients requiring first premolar extraction were selected. Following teeth extraction radiographic guided micro incisions and localized piezocision corticotomy was performed on the side selected as study side. Time elapsed to close the space by both conventional technique and corticotomy was noted.A repeated measure ANOVA was used to compare the duration of canine retraction between both the sides. A significant difference in duration of space closure was seen.It was concluded that likewise conventional corticotomy technique flapless piezocision technique was also a successful method of orthodontic tooth movement; but this is less invasive and more comfortable to patients.
Keywords: Corticotomy; minimally invasive; accelerated orthodontics

Background:Hypertensive disorder of pregnancy is a major cause of maternal and perinatal
morbidity and mortality in developing countries. The obstetrical use of Doppler sonography for
monitoring high-risk pregnancies is today an indispensable procedure. Hence; the present study
was conducted for assessing the effeteness of Doppler in Patients with Pregnancy Induced
Hypertension.Materials & methods: A total of 20 pregnant patients between 28 to 36 weeks of
pregnancy clinically diagnosed as PIH. Control group comprised of 20 patients with 28 to 36 weeks
with no clinically detectable hypertension. Inclusion criteria Comprised of patients with rise of
atleast 30 mm Hg and 15 mm of Hg in systolic and diastolic pressures respectively over the previous
known blood pressure, patients whose previous blood pressures were not known, the blood pressure
of atleast 140/90 mm of Hg were considered abnormal, singleton pregnancy, regular periods and
normotensive pregnant patients with gestational age between 28 to 36 weeks of gestation. Blood
pressure was recorded and ultrasound examination was done followed by Doppler. All the results
were recorded and analysed using SPSS software.Results: A total of 20 patients were included in
the study group and 20 subjects were enrolled in the control group. In the study group, normal S/D
ration was seen in 12 subjects while abnormal was seen in 8 subjects. Among the subjects with
abnormal S/D ratio, still birth and low birth weight were seen in 4 subjects and 3 subjects
respectively. Conclusion: Doppler velocimetry is useful in distinguishing the serious patients from
those where the approach can be a bit more conservative.

Background: Type 2 diabetes (T2D), is also known as adult-onset diabetes, it is characterized by raised in blood glucose levels, insulin resistance, and relative lack of insulin. Most of the cases of diabetes is due to gene polymorphism, the transcription factor-7-like 2 (TCF7L2) gene has been found as the most important gene to cause type 2 diabetes mellitus (T2DM). The main aim of the study is to study the effect of mono drug therapy in TCF7L2 gene associated type 2 diabetes mellitus.
Material and Methods: Prospective, randomised study. Group A- Metformin and Group B - Glimepride.  
Results:  TCF7L2 gene is associated with Type 2 diabetes mellitus. Genetic investigation was done in all 20 patients three genotypes have been identified CC, CT and TT genotypes in both the groups. Baseline values are higher in TT genotype when compared with CT & CC genotypes. In all group there is a significant improvement in blood glucose levels were as a controlled lipid profile was observed in CC genotype of Group A but no significant was observed in CT, TT and in group B genotypes.
Conclusion: Patients HbA1c ranges from 6.5 to 7.5 % prescribed with mono drug therapy of metformin and Glimepride shows significant improvement in blood glucose levels in all three genotypes but no significant was observed in CT, TT and Glimepride treated groups. As a result metformin is the better drug of choice in CC genotype associated type 2 diabetes mellitus when compared with Glimepride.
Keywords:  TCF7L2 gene, metformin, Glimepride

Aim: The purpose of this study to determine the prevalence of dermatological lesions in patients with diabetic retinopathy.
 Methods: This cross sectional study was done the Department of Ophthalmology, Madhubani Medical College and Hospital, Madhubani, Bihar, India for 10 months. 120 patients with diabetic retinopathy having diabetes mellitus of at least 5 years duration, aged between 30-65 years, were included in this study. The dermatological examination was done by a dermatologist under proper day light and if needed, using hand held magnifying lens. Examination of the retina was done by an Ophthalmologist using indirect ophthalmoscopy of dilated fundus, fundus photo, fundus fluorescein angiography and optical coherence tomography of the macula.
Results: There was a slight female preponderance with 51 males (42.5%) and 69 females (57.5%) among the 120 patients. of the 120 diabetic patients included in this study, 11(9.17%) had Very Mild Non Proliferative Diabetic Retinopathy (NPDR), 37(30.83%) had Mild NPDR, 43(35.83%) had Moderate NPDR, 14(11.67%) had Severe NPDR, 15(12.5%) had Proliferative Diabetic Retinopathy (PDR) and 49(40.83%) had Clinically Significant Macular Edema (CSME). 97 among 120 DR patients had different types of dermatological lesions, the prevalence being 80.83%. Dermatological lesions among poor glycemic control DM patients had a prevalence of 55% which was higher as compared to 35% among good glycemic control DM patients. 49(40.83%) patients had diabetic dermopathy, 37(30.83%) had Xerosis, 32(26.67%) had IGH, 28(23.33%) patients had Icthyosis, 8(6.67%) patients had Intertrigo, 6(5%) patients had Tinea Versicolor, 5(4.17%) patients had Chronic Paronychia and 5(4.17%) patients had Tinea Unguium. 4(3.33%) patients had Eczema, 3(2.5%) had Melasma, 3(2.5%) had Lichen Amyloidosis, 3(2.5%) had Varicose vein, 2(1.67%) had Fissure feet, 2(1.67%) had Pigmented Purpuric Dermatosis (PPD), 2(1.67%) had Dermatosis Papulosa Nigra (DPN), 1(0.83%) had Sclerodactyly, 1(0.83%) had Plain warts, 1(0.83%) had Macular Amyloidosis, 1(0.83%) had Cherry Aneurysm, 1(0.83%) had Xanthelasma Palpebrarum, 1(0.83%) had Photodermatitis, 1(0.83%) had Skin tags, 1(0.83%) had Onychomycosis, 1(0.83%) had Onychogryphosis and 1(0.83%) had Prurigo.
Conclusion: Prevalence of Dermatological lesions in Diabetic Retinopathy patients was 80.83%, the most common being Diabetic Dermopathy (shin spots) which was 40.83%.

The new public health crises were threatening the world with the emergence and spread of patients suffering from novel coronavirus (SARS-CoV-2). The epicentre of this highly contagious disease was Wuhan city, China, in December 2019. The World Health Organization (WHO) has verified the outbreak of novel coronavirus (2019-nCoV) as a global public health emergency of International Concern (PHEIC) (2). Currently, the major concern and clinical research on novel Coronavirus is inadequate or still in the primary stage Urgent need to develop safe and effective countermeasures that can be available, accessible and suitable for use in populations most in need. The outbreak is associated with exposures that surfaced in a Chinese seafood wholesale market. The novel virus, previously called the 2019-novel coronavirus (2019-nCoV), is currently designated as the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), WHO officially named the disease COVID-19 in February 2020 and is registered by International Committee on Taxonomy of Viruses (ICTV). The observed variability in susceptibility to SARS-CoV-2 and severity of the ensuing COVID-19 have raised intense interest in their environmental and genetic risk factors. An early report from China suggested that blood group A was associated with increased susceptibility and blood group O was associated with reduced susceptibility to SARS-CoV-2 infection

When the lifetime of an item follows an Exponentiated inverted Weibull Distribution, a group acceptance sampling plan based on reduced lifetimes is developed in this article. The minimal number of groups and acceptance number required for a particular group size are determined for a specified consumer's risk and the test termination time. The minimum ratios of the true average life to the prescribed life at a certain producer's risk are determined using the values of the operational characteristic function for various quality levels. Examples are used to demonstrate the conclusions.

Severe acute respiratory syndrome coronavirus 2 (SARS CoV 2) is the virus that causes COVID-19 (coronavirus disease 2019), the respiratory illness responsible for the COVID-19 pandemic. It has created a devastating effect on humanity with social and economic depression. Europe and America were the hardest hit continents. India has also lost lives, making the country fourth most deadly worldwide. However, the infection and death rate per million and the case fatality ratio in Uttar Pradesh were substantially lower than in many States in India. Several factors have been proposed including genetics. One of the important facts is that a large chunk of Uttar Pradesh population is asymptomatic to the SARS-CoV-2 infection. Thus, the real infection in Uttar Pradesh is much higher than the reported number of cases. Therefore, the majority of people are already immune in the states. To understand the dynamics of real infection as well as the level of immunity against SARS-CoV-2, we have performed antibody testing (serosurveillance) in the urban region of ten districts in Uttar Pradesh in our survey, the prevalence frequency varied between 0.01-0.48, suggesting high variability of viral transmission between District. We also found out that the cases reported by the government were several folds lower than the real incidence of infection. This discrepancy is mainly driven by the higher number of asymptomatic cases. Overall, we suggest that with the high level of immunity developed against SARS-CoV-2 in the majority of the districts, the case fatality rate of second wave in India will be minor than first wave.

Background: The incidence of oral cancers is increasing every year across the globe. India is of the countries which shares a high burden of oral malignancies owing to habits such as beetle chewing, smokeless tobacco use, smoking, and alcoholism. the current study aimed to describe the spectrum of clinical features in patients with oral malignancies along with the determination of etiological factors for oral malignancies reporting to our hospital.  
Methods: this cross-sectional study was conducted in the Department of ENT, Govt. ENT Hospital, Osmania Medical College, Koti, Hyderabad, Telangana. All the suspected cases with oral lesions were subjected to detailed history, clinical examination, and under local anesthesia with 10% xylocaine spray using Luc’s forceps biopsy was taken from edge of lesion and sent for histopathological examination.
Results: Highest frequency of malignancy was observed in the 31 – 50 years age group with 54% of all cases. Squamous cell carcinoma was diagnosed by histopathology in 97% cases, adenocystic carcinoma in 2% cases, and myoepithelial carcinoma in 1%. Tobacco chewing was the commonest etiological factor in all the cases. The common site of involvement was tongue in 39% of cases, buccal mucosa in 28% cases, retromolar trigone in 14% cases.
Conclusion: Reduction in the burden of oral cancers can be achieved by reduction of risk factors, tobacco consumption, health education, and improvement of lifestyle. Additionally, recognizing and controlling precancerous lesions and early diagnosis of oral lesions, and initiation of appropriate therapy at initial stages will reduce morbidity and mortality associated with oral cancers.   

Background: Anal Fissure and Fistula can be hard to ignore, particularly with symptoms such as itchiness or pain and bleeding in the rectal area. Anal fistula is a pathological connection between the anal canal and perianal skin, which most commonly develops from an infected anal crypt.
Aim: To search for the prevalence and treatment of a fistula in patients with chronic anal fissure (CAF).
Method: We started to look the presence or absence of any local sequels in 73 patients around the fissure in consecutive patients with CAF. The duration of symptoms and a history of previous abscess formation and/or drainage were asked in detail. In patients with fissure-fistula, fistulotomy/ fistulectomy was first performed because this part of the operation necessitated division of some of the IAS in some cases. The patients were examined on the 8th postoperative day, 1 month & 6 months postoperatively.
Results: Patients who underwent surgery for anal fistula were analyzed. Of the 73 patients (aged 18-60 years), 47 (64.38%) were males and 26 (35.62%) were females. 46 (63%) patients were treated with LIS only; 18 patients (24.66%) were treated with LIS + sentinel pile excision and 9 (12.34%) were treated with LIS + fistulotomy with/without abscess drainage.
Conclusion: It is the determinant of CAF in the success of the treatment of anal fistula developing on the basis of CAF. Adequate sphincterotomy is successful in the treatment of CAF and anal fistula developing on the fissure background.

Purpose: To study the serum lipid levels of patients with retinal vein occlusion and compare the lipid levels with age matched control group, also correlate with RVO induced macular edema.
Study Design: A comparative study.
Methods: This was a  comparative study. Total 172 patients were included. Among them there were around 86 patients /cases in group1, (26 CRVO, 55 BRVO, 5 HRVO) diagnosed  and 86 controls (selective age matched) in group 2 enrolled into the study. Group 1 cases were those who meet our inclusion and exclusion criteria. After taking informed consent, detailed history taken and thorough ophthalmological examination was done, All patients with retinal vein occlusion in group 1 underwent optical coherence tomography scan to assess macular edema to detect central retinalthickness. Later they were advised for fasting serum lipid levels in an advanced biochemistry laboratory.
Results: Total cholestrol, triglycerides , HDL, LDL levels were elevated significantly in cases with RVO group 1 as compared to age matched controls group 2.
Conclusion: Hyperlipidemia is a common independent risk factor for occurrence RVO in adults. Total cholesterol, Triglycerides, LDL levels were raised (p-value <0.001) and HDL levels were reduced (p value <0.001) in patients with retinal vein occlusion as opposed to age matched comparison control group which was statistically significant. Hyperlipidemia are common risk factors for RVO in adults. It remains to be determined that serum lipid levels can improve visual acuity or the complications of RVO

Background : Chronic nasal obstruction commonly defined as patient discomfort manifested as a sensation of insufficient airflow through the nose, and also is one of the most common human problems and a very frequent symptom in the otorhinolaryngology field. Chronic nasal obstruction has many adverse sequelae.
Objective : To evaluate the effectiveness of submucosal diathermy of inferior turbinate versus turbinoplasty in patients with inferior turbinate hypertrophy.
Material and Methods : A Prospective Comparative Study conducted at Department of ENT, Narayana Medical College, Nellore for the period of one years, with sample size of 50 (Each Group having 25 Samples). Symptomatic patients with bilateral inferior turbinate hypertrophy and age group 15 to 55 years were included in the study. Prior to surgical intervention patient is asked to fill in the SNOT-22 questionnaire includes patients rated 22 different symptoms related to both nasal and general heath on a score of  0 to 5  T-test were used to see the difference between means. Data were presented by mean and proportions, 5% significance were taken to asses the mean difference.
Results : Study had total 50 patients in which 20 were males, and 30 were females. Overall mean age of the patients was 29.28 years with standard deviation of 8.15 years., it was found that Nasal Obstruction improvement in Turbinoplasty was 84% compared to Submucosal Diathermy. Similarly Nasal Symptoms, Non-Nasal Symptoms and also general Health Symptoms proportion of improvement was more in Turbinoplasty as compared to the Submucosal Diathermy, and this improvement between the therapy was statistically significant. (P-value<0.01)
Conclusion : From overall observation and discussion we observed that  Turbinoplasty is found to be more effective than submucosal diathermy in reducing the nasal obstruction and other nasal symptoms.

Background: Human immunodeficiency virus (HIV) a lentivirus that acquired immuno deficiency syndrome (AIDS) in which there is progressive failure of the immune system with life threatening opportunistic infections and cancers. So there is a need to identify and establish relationship between serum albumin level with disease severity in HIV/AIDS patients.
Methods: This is cross sectional study was conducted on 81 HIV/AIDS patients presenting to and registered ART center at Chalmeda Anand Rao Institute of Medical Sciences, Karimnagar, during the period from September 2020 to June 2021. A detailed history, clinical examination and laboratory investigations was done.
Results: Our study the mean serum albumin level was 3.11 + 0.50. There was a significant correlation between serum albumin level with CD4 + counts was 0.627.
Conclusion: Study indicating that albumin could be used as a supplementary marker for immunosuppression in HIV/AIDS patients.

Background&Method: This is a retrospective study carried out with an aim to study the
concentration of anti-B2GPI (IgG and IgMisotypes) in patients with collagen vascular diseases
(auto-immune disorders), pregnancy related complication and thromboembolic disorders, in
patients who were tested for anti-B2GPI (IgG and IgM) and ACL (IgG and IgM) by the
standardized solid-phase enzyme linked immunosorbent assay (ELISA) in pathology department.
Result:The 38 patients with SLE presented with common clinical manifestations of SLE. In
addition, Raynaud’s phenomenon (n = 3) and photosensitivity (n = 4) were seen in a few.
Further, two each of patients with SLE had auto-immune hemolytic anemia, and history of
spontaneous abortions respectively. One of the two patients with spontaneous abortions had a
past history of a vertebrobasilar infarct. Renal involvement was noted in 13 (34.2%) cases, out of
which 11 had biopsy proven lupus nephritis, one case had mild mesangial proliferation and in
one ultrasound of the abdomen had shown medical renal disease. One patient had a clinical
diagnosis of deep vein thrombosis however results of radiological tests for confirmation if done
were not available. One other patient had pulmonary hypertension. The patient with primary
APS had presented with seizures and post-ictal confusion.
Conclusion:In present study ACL (IG & or IgM) was noted to be more prevalent than anti-
B2GPI (IG & or IgM) in patients with collagen vascular diseases (auto-immune diseases) and
thromboembolic disorders while they showed a similar prevalence in patients with recurrent fetal
losses. While we observed that there were certain differences in the prevalence of these
antibodies when compared to other published studies, this could be related to differences in
patient selection.

Background: "Hypertrophic scars" are excessive scars with thick fibrous tissue that
does not extend beyond the margins of the initial wound or incision. They're usually
broader than they need to be for regular wound healing. Following excision,
intraoperative and postoperative intralesional steroid treatment has been proven to
minimise recurrence to less than 50%.
Materials and Methods: This is a prospective and single centre study conducted in the
Department of General Surgery, Maheshwara Medical College & Hospital from 1st
September 2020 to 4th September 2021. Males and females in the age group between 18
and 60 years were included in this study. The split thickness skin graft was harvested
from a normal thigh where no skin graft had been harvested earlier. Indications for
skin grafting were both elective and emergency.
Results: In our study, male was predominant 72.5% and remaining was 27.5%. Among
the study group, 67.5% were post burn contracture raw areas, 30% posttraumatic raw
areas and 3% post infective raw areas. Among 40 donor site steroid injection sites 9 are
hyperpigmented (dark), 9 are hypo pigmented and 20 are similar in colour with
surrounding skin compared to 20 (hyper), 13 (hypo), 7 (iso) respectively at donor site
control areas. Mean value of normal skin thickness is 1.70, test site skin thickness is 2.30
and at control site skin thickness is 2.70. In our study57.5% cases have mild pain at test
site, 42.5% cases have no pain at test site and 45% have moderate pain at control site in
the post-operative period.
Conclusion: Reduced scar diameters, height, scar texture, colour match, and
symptomatic relief were found in our investigation, with little dose-related druginduced
adverse effects. With regard to pigmentation and thickness, employing post
operational intra lesional triamcinolone acetate injection after harvesting skin grafting
resulted in a superior cosmetic and symptomatic outcome in skin grafting donor
locations.

Serous retinal detachment is an unsual cause of vision loss in preeclampsia. We report 21 year old patient with blilateral retinal detachment that resolved spontaneously following conservative management

INTRODUCTION: Chronic respiratory failure due to chronic obstructive pulmonary disease (COPD) contributes a significant social and economic burden to individuals, families and the healthcare system. One of the limitations of traditional NIV is altered levels of consciousness. However, under certain circumstances, especially those produced by hypercapnic conditions, traditional NIV has produced very favorable results, even in patients with hypercapnic coma.
METHODOLOGY: A hospital based, prospective, observational study done on 176 patients of AECOPD with type 2 respiratory failure admitted at Institute of Respiratory Diseases, National Institute of Medical sciences, Jaipur. Necessary permission was taken from Ethical Committee and Research Review Board of National Institute of Medical science, Jaipur.
RESULTS: Our study showed that the comparison of mean age was statistically non-significant (=0.5979 NS) and duration of disease was statistically significant (P=0.0004*).  Our study showed that the mean value of pH, PaCO2, PaO2 and SaO2 was statistically non-significant at admission and after 3 hours in between groups, but HCO3- & Respiratory Rate was statistically significant at admission and after 3 hours in between groups. pH and PaCO2 was statistically significant after 6 hours in between groups. 
CONCLUSION: We concluded that NPPV should be the first line intervention in addition to usual medical care to manage respiratory failure secondary to an acute exacerbation of chronic obstructive pulmonary disease in all suitable patients. NPPV should be tried early in the course of respiratory failure and before severe acidosis, to reduce mortality, avoid endo-tracheal intubation, and decrease treatment.

Background &Method: The aim of the study is to determine lipid status in one of the common neurodegenerative disease i.e Parkinson’s disease patients. 5 ml fasting blood samples from patients sex & age matched controls were collected from antecubital vein, with all aseptic precaution in plain vacutainers.
 
Result: Serum total cholesterol level and LDL cholesterol was significantly low in Parkinson’s patients as compared with control group. Serum HDL cholesterol level was slightly low, but not significantly different as compared with controls.
 
Conclusion: Finally from our work we observed that Serum Total cholesterol and Serum LDL cholesterol levels are significantly decreased, in Parkinson’s disease patients as compared with controls. Serum HDL cholesterol is slightly decreased & did not show any statistical difference in Parkinson’s disease patients as compared with healthy controls suggesting dysregulation of lipid metabolism in PD patients.

Background: The pituitary gland was first described anatomically by a Belgian scientist Andreas Vesalius in 1543.Pituitary gland is the master endocrine gland of human body Magnetic Resonance Imaging (MRI) is the most suitable modality for the evaluation of pituitary gland pathologies. Knowledge of the normal dimensions of the pituitary gland is needed to differentiate normal from abnormal cases. Size of the gland especially height varies according to age group and also gender. The references values are helpful for evaluating pituitary gland especially in borderline cases in whom dynamic post contrast studies are needed for further evaluation. Hence we conducted a study to formulate the normal data for different age groups.
Aim of the study: Aim of the study is to evaluate the size and shape of pituitary gland according to different age groups on MRI.
Materials and Methods: This was a retrospective study conducted in the department of Radiology, Government Medical College, Baramulla, Jammu and Kashmir, India, a tertiary care teaching hospital. 203 patients who had undergone brain MRI, Patients with seller or parasellar pathologies and endocrine disorders were excluded from the study. Mid sagittal T1 weighted images were analysed for size and shape of the gland.
Results: Our study included 203 patients, 112 males and 91 females. The patients were divided into different age groups from 0 to 10 years, 11-20 years, 21-30 years, 31-40 years, 41-50 years, 51-60 years and 61 years and above. Mean height of pituitary gland in our study was 5.42 mm. Maximum height was found in 11-20 years age group. After 11-20 years age group, gradual decline in the height was noted. Minimal increase in the elderly age group was also seen. Most common shape of the pituitary gland was flat in our study.
Conclusion: The reference value of normal size of pituitary gland in various genders and age groups has been standardized. Any variation in size will help the clinician to deduce any pathology and make early diagnosis and plan adequate this will be avoid unnecessary suffering to patients. Knowledge of pituitary gland height in different age groups is helpful in distinguishing normal from abnormal gland. Normal data of the study is useful for the same.

Background: Stroke specifically the type due to cerebrovascular disease is defined as a sudden, non-convulsive focal neurological deficit. The terms “apoplexy” originating from the Greek and insult from the Latin “insultus” described stroke phenomenon in ancient times. Cerebrovascular accident is a leading cause of death and disability throughout the world. It is a common cause of death after heart disease and cancer in India. Accurate and early diagnosis can improve the morbidity and mortality rates, as newer and more effective therapies are currently being instituted. Since computed tomography imaging is widely available, cost effective and less time consuming, it plays the role of first line imaging modality.
Aims and objectives: The purpose of the present study is to document the presence or absence of haemorrhage or infarcts, to determine the location and reasonably assessing the territory to blood vessels involved and to detect the incidence of negative cases of clinically suspected stroke.
Materials  and  Methods:  A prospective study of 62 cases admitted to Department of Radiodiagnosis, Government Medical College, Baramulla, Jammu and Kashmir, India with the clinical diagnosis of acute stroke were taken up for the study. Data for my study is collected by sampling referred cases with a clinical history of stroke.
Results: Out of 62 patients clinically suspected of CVA submitted for CT scan study of the brain. 40 patients i.e., 64.5% had infarcts. 15 patients i.e., 24.2% had haemorrhage, 3 patient i.e., 5% had S.D.H., 2 patients i.e., 3.33% had C.V.T. 1 patient i.e., 1.6 % had tumour and 1 patient i.e., 1.6% had normal scans. Infarcts formed the major group of the CVA cases i.e., 64.5%, involving most commonly the R.M.C.A. territory in patients i.e., 26.31%. Haemorrhage formed the second major group of the CVA cases i.e., 25%, involving most commonly the L.M.C.A. territory in patients i.e., 26.66%. 

Background: The shoulder joint is a ball and socket variety of joint with wide range of movements in multiple planes where stability is compromised for mobility. The muscles and tendons are subjected to severe strain resulting in tears. Rotator cuff disease is one of the most common causes of shoulder pain. In addition to history and physical examination, several radiological techniques have been used to detect tears of the rotator cuff. Each has limitations and no clear consensus on the optimum diagnostic study has emerged. The radiological diagnosis of rotator cuff tears has traditionally been performed with arthrography and more recently with non-invasive techniques like ultrasonography and MRI.
Aims and objectives: Evaluation of role of MRI in rotator cuff injuries, evaluation of role of high resolution ultrasound in rotator cuff injuries. Correlation of clinical and high resolution ultrasound findings with MRI findings.
Materials and Methods: In our study we took over the analysis of 32 patients with clinically suspected rotator cuff injuries were subjected to undergo USG and MRI after thorough history taking and clinical examination. USG was carried out on IU22 Philips machine using a high frequency transducer of 5-17 MHz. The rotator cuff tendons, muscles, ACJ, joint cavity and bursae were examined in various positions. Dynamic examination of shoulder were also carried out for impingement. MRI was performed on 1.5 Tesla MRI scanner, using a dedicated surface coil for shoulder.

The term bad obstetric history or BOH is applied to mothers in whom a previous poor pregnancy outcome is likely to have a bearing on the prognosis of her present pregnancy. Poor pregnancy outcome may be there in form of recurrent pregnancy loss, stillborn baby or intrauterine death of fetus (IUD) which not only increases the perinatal mortality rate but also results in deterioration of physical as well as psychological health of women. There are number of causes which are responsible like genetic or chromosomal disorders, structural abnormalities, endocrinal dysfunction, infections, immunological factors, maternal diseases like anaemia, preeclampsia etc. Despite of regular antenatal care, investigations and management, sometimes the cause remain unknown for the pregnancy loss. In Ayurveda , Acharya Charaka mentioned the factors responsible for normal delivery of normally developed full term fetus as Shukra (healthy sperm), Asrig (healthy ovum), Atma (good deeds), Ashaya (healthy uterus), Kala (appropriate time), diet and mode of life mentioned for pregnant woman in Ayurveda. Ayurveda provides various drugs possessing Rasayana, Balya, Garbhasthapaka, Garbhaposhaka, Prajasthapaka and Shonitaprasadana properties which helps in continuation of pregnancy, proper growth and development of fetus overcoming all complications and simultaneously maintaining the health of mother. In the present case study, patient with history of 3 abortions and 1 Intrauterine death (IUD) was given Ayurvedic medicines to prevent any complications in present pregnancy resulting in delivery of healthy full term baby.

Introduction:  Polymorphisms of the different genes have been reported to be associated with a variety of cancers including breast cancer. CYP genes belongings to Cytochrome P450 (CYP450), have been implicated in various cancer formation and development due to their roles such as oxidative stress, activating procarcinogens, and inactivating anticancer drugs.
Objective: This study aimed to examine whether polymorphisms in the CYP3A4 and CYP3A5 genes affect the risk of developing breast cancer.
Results: CYP3A4*1B gene polymorphism revealed that in breast cancer patient group 96 had the *1A/*1A genotype  (64%), 39 (26%) had the *1A/*B genotype and 15 (10%) had the *1B/*B genotype. In the control group 131 (87%) had the *1A/*1A genotype, 16 (10.66%) had the *1A/*B genotype and 3 (2%) had the *1B/*B genotype. Concerning genotype distribution, a significant difference between the breast cancer patients and the controls was observed where p<0.05) The genotype frequency of the CYP3A5*3 *1/*1, *1/*3, and *3/*3 polymorphisms in breast cancer and healthy control group were analysed. Frequencies of CYP3A4*3 *1/*1, *1/*3 and *3/*3 genotypes were 67.3%, 24% and 8.7 % in breast cancer patients and 79.3%, 14% and 6.7% in the controls, respectively. The distribution of CYP3A5*3 *1/*3 genotypes was significantly associated with breast cancer patients when compared with controls.
Conclusion: In conclusion, the results of our study found a positive association between CYP 3A4*1B and CYP3A5*3 polymorphisms and predispositions to breast cancer risk.
 

Background: Vaginal infection is acknowledged as a significant public health issue that affects women of reproductive age and results in a number of issues. The technique of contraception that is used increases the risk of genital infection. The most frequent cause of vaginal discharge in women of reproductive age is bacterial vaginosis. Although the typical vaginal flora differs from person to person, lactobacilli are often the dominant organism. There are other aerobic and anaerobic species in the bacterial flora. These are regarded as pathogenic in some cases. It is known that pelvic inflammatory illness, preterm premature rupture of the membranes (PROM), post-operative gynecologic infections, and abnormal Papanicolaou smear can all be indicators of bacterial vaginosis.

Objective:To describe the clinical, radiological and laboratory profile and to form a report concluding statistics of COVID-19 positive paediatric patients at our centre during study period. Design: Hospital based observational study. Setting: Government Tertiary care hospital. Participants: COVID-19 positive children admitted from 20th April 2020 to 31st March 2021. RTPCR of respiratory secretions was done for diagnosis. Intervention: Detailed history and examination were performed and relevant investigations were sent Outcome Measure:Outcome was expressed in form of discharged or expired.
Results:Out of 421 cases enrolled, 375 cases were discharged after fulfilling discharge criteria and 26 cases expired. Asymptomatic cases constituted 54.1% of the total cases. Among the symptomatic cases, fever, cough and shortness of breath were the chief symptoms reported in 31.9%, 16.1% and 12.35% respectively. Most common laboratory finding was lymphocytosis seen in 59.2% patients; raised levels of markers of inflammation like CRP, ESR were seen in 66.6% patients.
Conclusion: Majority of paediatric patients were asymptomatic and had mild disease. Symptoms related to the gastrointestinal tract like diarrhea and vomiting were other important symptoms along with the respiratory and general symptoms. 64.2% cases had household exposure to infection.

Diabetes mellitus (DM) has a high prevalence worldwide. Anaemia is one of the most common conditions seen in diabetic patients which is the leading cause of morbidity in these patients. It leads to various complications, including microvascular and macrovascular complications. The nephropathy may undermine the renal production of erythropoietin, positively contributing to an increased anemia framework. The inflammatory situation created by kidney disease also interferes with intestinal iron absorption. Therefore, diabetic patients with kidney disease have higher risk for developing anemia.
Aim : The aim of this work was to determine the prevalence and various types of anemia in patients with type 2 DM.
Methods : After obtaining informed written consent, all diabetics as well as control individuals were subjected to detail history, clinical examination, and investigations as follows: fasting blood glucose, postprandial blood glucose, glycated hemoglobin, complete blood count, peripheral smear for type of anemia, reticulocyte count and renal function test, creatinine clearance, urine examination, albuminuria, and stool examination through routine and microscopic fecal occult blood test.
Results : The prevalence of anemia among our studied patients with type 2 DM was 65%, with significant increase compared with the control group (10%). Diabetics had microcytic hypochromic anemia among 55%, whereas 44.6% had normocytic normochromic anemia. There was a significant negative correlation between hemoglobin level and degree of albuminuria and a significant positive correlation between hemoglobin level and creatinine clearance.
Conclusion : Anemia is a common finding in patients with type 2 DM when compared with the general population. Hence in diabetic patients, it would be desirable to evaluate the hemoglobin levels often, even when the renal parameters are within the normal limits, for better quality of life.