of the jaws. Rather than true neoplasm, odontomas are considered to be hamartomas. Usually odontomas are found to be asymptomatic, although a few incidences of swelling, delayed eruption of permanent tooth and in severe cases, infection or lymphadenopathy has been reported. Multiple complex odontomas pose a therapeutic challenge in some cases especially in the mandible due to proximity of vital anatomic structures. They have also been associated with complications like cystic transformation. Here we are presenting a case of multiple complex odontomas in the maxilla and mandible in a 32-year-old male patient.

The term “pigmentation of oral mucosa” is applied to a wide range of lesions or conditions featuring a change of color of oral tissues. Common causes of mucosal coloration including petechiae, purpura, ecchymoses, hematomas, vascular tumors and exogenous substances are not true pigmented lesions. In contrast, melanin which is synthesized by melanocytes, is a true pigment and usually imparts a brown, blue or black appearance of the mucosa. Oral pigmentation affects about 3%of the total population and most likely in those with dark skin, more prevalent in females than males during the 3rd or 4th decade of life. In this review, we are describing the oral manifestation and dental considerations associated with common pigmented disorders which will allow the practitioner to have a holistic approach in diagnosis and management of these patients.

Introduction: Despite ongoing advances in the treatment of chronic kidney disease (CKD), the mortality rate, and level of health-related quality of life (HRQOL) for the CKD population remain significantly higher than for the general population. The importance of measuring end-stage renal failure (ESRF) patients' quality of life in relation to healthcare lies in not only providing absolute survival but also the quality of that survival. Due to cost constraints, the profile of chronic kidney disease patients and their treatment in Bangladesh is almost identical to that of India, with patients frequently requesting a reduction in the frequency of dialysis sessions, the use of less expensive dialyzers, dialyzer reuse, and the absence of erythropoietin therapy. Hence, augmenting the QOL may perhaps be a challenge and an observable fact of specific interest for renal healthcare teams. This study is intended to assess KDQOL among patients receiving hemodialysis for 8 hours, and 12 hours per week, patients receiving CAPD, and patients of CKD stage V who decline any form of renal replacement therapy, and remained on conservative treatment. The aim of the study was to assess the quality of life among patients of CKD Stage V. Methods: This cross-sectional study was carried out at the Department of Nephrology, Dhaka Medical College Hospital and BIRDEM general hospital. The patients who received consultation at the Outdoor Department of selected hospital from November 2010 to October 2011. The study assess the of Quality of Life, and Cost Effectiveness on different modalities of treatment among the patients of chronic kidney disease stage V, and also to find out the best modality of dialysis. A total number of 134 consecutive patients were enrolled in this study, out of which 42 patients who were advised to commence renal replacement therapy, and after counseling opted to remain in conservative treatment were considered as GROUP I, 39 patients who received hemodialysis 8 hours per week were considered as GROUP II, 30 patients who received hemodialysis 12 hours per week in one or more centers were considered as GROUP III, and 23 patients who received Continuous Peritoneal Dialysis at least 3 exchanges per day were considered as GROUP IV. Result: Mean age was almost similar in all four groups, and most of the patients were 5th decade, and above. Male was predominant in all four groups, and the male-female ratio was almost 2:1 in the whole study patients. Diabetic nephropathy and glomerulonephritis were more common etiology of CKD in all four groups. Monthly expenditure was significantly (p<0.05) higher in group IV, followed by group III, group II, and group I in all three follow-ups, however, monthly expenditure was almost similar between group III, and group IV (p>0.05) but the mean monthly expenditure was higher in group IV patients. Mean serum Creatinine was lowest in group IV followed by group III, group II, and group I in descending order. Serum albumin was low in all the groups but almost parallel in all follow-ups in group II, groups I, and group IV, whereas the lowest was in group II followed by group I and group IV, but declined in group III during the 2nd, and 3rd follow-up from 1st follow-up. Hemoglobin level consistently remained within the target range in group IV in all follow-ups but below the target range in group I followed by group II, and group III in ascending order. The physical component score increased significantly in Group III, and Group IV at consecutive follow-ups, however, it was higher in Group IV. Similarly, the mental component score was recorded highest in Group IV, followed by group III, group II, and group I. Regarding mortality, it was observed that more than half of the patients were expired in group I, one-third in group II, and 16.7% in group III, and only 8.7% in group IV during final follow-up. Conclusion: Patients receiving continuous ambulatory peritoneal dialysis achieved the best clinical parameters in terms of control of blood pressure, and volume overload. On the other hand, parameters were a lot away from the desired target in patients receiving hemodialysis for 8 hours per week, and they did not have significantly better parameters in comparison to those who were only on conservative treatment. The scenario of serum albumin, and serum creatinine, though complicated by the existence of malnutrition, were in best approximation to the desired level in these patients. According to the age-sex-matched risk categorization of the patients, it was found that the majority of patients on conservative treatment were in more than the average risk category.

This study aims to analyze the effect of organizational structure and readiness for change on employee engagement and good governance at the Department of Cooperatives, SMEs and Industry of Samarinda City. The sample is 71 permanent employees of the Department of Cooperatives, SMEs and Industry of Samarinda City who are involved as respondents and are given a questionnaire containing questions that must be answered by giving a score. The data analysis method used is the Structural Equation Model (SEM) analysis using the SmartPLS application. The results showed that there was a significant influence between each organizational structure on employee engagement, readiness for change on employee engagement, readiness for change on good governance, and employee engagement on good governance. However, it is found that readiness for change on good governance does not have a significant effect. Based on the results of the study, almost all variables have a significant effect, but only readiness for change on good governance does not have a significant effect, so whatever changes the organization do, employees of the Department of Cooperatives, SMEs and Industry of Samarinda City some are being not able or even not willing to implement the changes.

Background: In Ayurvedic classics Diarrhoea is described with the name of Atisaar. In modern science it is closely correlated with watery Diarrhoea which is defined as having loose or watery stools at least three times per day or more frequently than normal for an individual. Diarrhoea caused by bacterial pathogens is a global health problem, especially in developing countries and enteric bacterial pathogens are the main cause of infectious Diarrhoea. Ayurvedic literature have lot of unexplored or least tested medicine, Shadanga Ghrita is one of those Ayurvedic formulation used in the management of Tridoshaja Atisaar. But it has some disadvantages such as bitterness in taste, unpalatability, feasibility and inconvenience in transportation. Considering these, here an attempt was made to transform it into a new dosage form i.e., Ghana Vati. Aim & Objectives: Aim & objectives of present study was to evaluate the anti-bacterial activity of Shadanga Ghrita and its new dosage form on Diarrhoea causing enteropathogens. Material and Methods: Samples of Shadanga Ghrita & its Ghana Vati were prepared as per Sharangdhar Samhita Madhyama Khanda. All the samples of finished products were analyzed on organoleptic and physico-chemical parameters. Anti-bacterial study was done by using Well Diffusion Method and Muller Hinton Agar Media was used to evaluate anti-bacterial activity against S. aureus, E. coli, S. enterica, S. boydii, Y. enterolitica, A. species, and C. perfringens. Result: Both samples showed significant anti-bacterial activity against Diarrhoea causing enteropathogens. Conclusion: Shadanga Ghrita is more effective Antibacterial agent, as it was formulated by Sneha Paka Kalpana method; Gou- Ghrita has potentiated the anti- bacterial effect of it.

MTA® is considered as the biomaterial of choice because of its excellent characteristics. Biodentine™ has been introduced into periapical surgery and has proven its efficacity in sealing root-end cavities. Despite of the desirable properties of BiodentineTM, there are limited published cases that described the use of BiodentineTM in periapical surgery.

The present work mainly emphasized on the enhancement of solubility of Ticagrelor by developing Self- Micro emulsifying drug delivery system. Ticagrelor is a BCS class IV drug with poor aqueous solubility and permeability. The saturated solubility of Ticagrelor in various oils, surfactants and co-surfactants was determined by using UV-spectroscopy. The excipients were selected based on their maximum solubility and compatibility for Ticagrelor. SMEDDS formulations od Ticagrelor were developed using different oils, surfactants and co-surfactant combinations (4:1 and 3:1). Pseudo ternary phase diagrams were constructed and based on pseudo ternary phase diagrams, Nano emulsification area was evaluated .Formulations were designed based on the pseudo ternary phase diagram using various proportions of oil (Capmul MCM E8 EP), surfactant (Labrasol), co-surfactant (PEG-400). The prepared formulations were selected among them F1 was optimized and carried out for further evaluations like dispersibility test, self-emulsification time ,phase separation and stability test, thermodynamic stability studies, droplet size and zeta potential, invitro drug release studies. The results of present study demonstrate that Ticagrelor SMEDDS can be used as a potential means for improving the solubility of Ticagrelor.

Background: Irreversible pulpitis occurs due to infection and other factors. Irreversible pulpitis needs root canal treatment to relieve the pain and achieve restoration of healthy teeth. The success rates of root canal treatment are based on adequate removal of the microorganism and the prevention of the re-growth of microorganisms. However, endodontic treatment isn't always successful. There are many factors affecting the outcome of root canal treatment. Aim: To identify the factors affecting the outcomes of root canal treatment by reviewing the previous studies conducted on this subject. Methods: PubMed, Google Scholar, and Research Gate databases were explored to search for articles related to our subject. The searching process involved using different keywords that were used in different combinations to obtain all possible articles focused on our subject. The inclusion criteria for studies were articles published in 2017 until now, English original and full-text articles. Results: A total of 158 articles were obtained, and only seven articles were eligible for the inclusion criteria. Four studies included treatment performed by dental students. The success rate of treatment ranged between 63.7% and 86.8%. The factors that affected the outcome of root canal treatment were categorized into factors associated with successful treatment, failure of treatment, and factors with no impact on treatment. Conclusion: The success rate of root canal treatment in our analysis was moderate. There were many factors affecting the root canal treatment outcome, including quality of filling, length of filling, and the absence or presence of a periapical lesion.

Background: Vesico-vaginal fistula (VVF) is still a persisting scourge in the developing countries with devastating medical and social consequences. These consequences were studied among patients presenting with vesico- vaginal fistula in Sylhet MAG Osmani Medical College Hospital, Sylhet. Objectives: To analyzethe vesico-vaginal fistula patients during the 2 years period. Materials and Methods: This was a descriptive and cross-sectional study conducted in the Department of Obstetrics and Gynaecology, Sylhet M.A.G. Osmani Medical College Hospital, Sylhet from May 2008 to April 2010 (2 years).Fifty-three hospitalized patients with vesico-vaginal fistula were selected by Inclusion and exclusion criteria, undergoing repair operation irrespective of age. After selection of the patients informed written consent was taken. Each patient was interviewed using the semi-structured questionnaire containing socio- demographic and other relevant information like age, occupation, education of the patient and her husband, age at marriage, age at 1* child birth, monthly income and detailed history of the delivery. Type of fistula and related examination of the fistula was also done and noted. Type of repair of vesico-vaginal fistula, postoperative complications and outcome was recorded in the same manner. Results: The mean age of the patients with vesico-vaginal fistula was 30.5 years (SD± 8.5; range, 18 to 52). Majority (73.6%) were between 21 to 40 years; and 52.8% patients were primipara, 81.1% patients were illiterate and 69.8%patientswere from lower social class. The aetiology of fistula were obstructed labour 49.1%, emergency lower segment caesarean section 37.7%, destructive delivery 11.3% and caesarean hysterectomy 1.9%.The repair operation was done of all patients in this series through vaginal approach. Repair was done first time in 83% and rest had history of failed repair. Postoperative complications were catheter block and urine leakage in 37.7% and urinary tract infection in 11.3% patients. Successful outcome was found in 79.2% cases. Causes of failure were severe scaring 36.5% difficult operation, catheter block and others each constituted 18.2% and large fistula 1.9%. Conclusion: Young primi are the victims of vesico-vaginal fistula, obstetric causes add up to form a major share of the etiology of vesico-vaginal fistula. Proper perinatal management is most important to reduce obs fistula formation.

Background: Magnesium plays an import role in the physiology of parturition. Decrease of Magnesium in plasma may be responsible for a decrease of the same in myometrium and this might have a considerable influence on the preterm labour. A Hypomagnesaemia leads to neuromuscular irritability leading to uterine hyperactivity which leads to cervical dilation. Objective: To find out the association between serum magnesium and preterm level. Methods: This was a cross sectional study, conducted in 100 women in labour, of them 50 were diagnosed case of preterm labour and 50 women were in labour at term attended in Gynaecology and Obstetrics department of Dhaka Medical College, Dhaka, from January 2015 to December 2015.5ml fasting blood sample was collected and was analyzed for serum magnesium using a standard enzymatic method. The mean value of serum magnesium was compared between two groups by student unpaired t-test and serum magnesium level was correlated with BMI, Gravita and gestational age in preterm labour patients by Pearson’s correlation coefficient test. A p-value was considered to be statistically significant at 0.05 at a 95% confidence interval. Results: The mean age was found 28.2±4.5 years in group I and 26.7±4.1 years in group II. The mean age difference was not statistically significant (p>0.05) between two groups. A majority (80.0%) of the patients came from a middle-class family in group I and 29(58.0%) in group II. The mean BMI was found 23.0±3.8 kg/m2 in group I and 26.4±2.4 kg/m2 in group II. The socioeconomic status and BMI were statistically significant (p<0.05) between two groups. The mean serum magnesium was found 1.64±0.13 mg/dl in group I and 2.05±0.11 mg/dl in group II. The mean serum magnesium level was significantly (p<0.05) lesser in group I. Serum magnesium had an area under curve 0.974, which gave a cut-off value < 1.8 mg/dl, with 98.0% sensitivity and 88.0% specificity for prediction of preterm labour. Conclusion: Most of the patients were belonged to age 21-30 years in both groups are not associated. A negligible correlation was found with BMI, gravid, through serum magnesium in preterm labour. Low serum magnesium level was significantly higher in preterm labour.

This study examines the sociolinguistics implication of the use of Nigerian Pidgin among HNDII students of the Federal Polytechnic, Nasarawa. Pidgin emerges when people from different linguistic backgrounds need a means of verbal communication. Interviews and direct observation methods of investigation are used as means of gathering data for the study. Fishman’s theory of domain analysis is employed as a framework of analysis for the study. The study discovered the presence of Nigerian Pidgin on campuses and how it affects to a great extent the teaching and learning of Standard English in Nigerian higher institutions. This study has also been able to provide answers to such questions as who speaks Nigerian Pidgin, to whom, where and for what purpose. The implication of the use of Nigerian Pidgin in academics was also explored. On the whole, this research concludes with the notion that Nigerian Pidgin is used as a means of informal communication among students on Nigerian campuses; as such, it has negative implications on the teaching and learning of Standard English in our educational process.

Objective: This systematic review is aimed to review the role of uterine artery Doppler in first trimester of pregnancy along with use of maternal characteristics as a predictor of early and late on set pre-eclampsia (PE). Selection Criteria: The search was limited by selecting; only original articles, prospective & retrospective study designs, role of uterine artery Doppler done at 11 to 14 weeks, done on singleton pregnancy and written in English language were included. Data Collection and Analysis: The data extracted for author name, year of publication, place of study, duration of study, study design, outcomes and study variables including maternal factors, uterine artery Doppler and serum markers. Then detailed analysis of uterine artery Doppler performance as predictor in the form of Area under curve, Sensitivity, Specificity, Positive predictive value, Negative Predictive Value and its relation to preeclampsia, Early PE and Late PE. Results: Following the search strategy of PRISMA, 148 full articles reviewed, and 21 articles were included from 2010 to 2021. Out of 21 articles, 19 articles had “prospective study design” whereas two had “retrospective. Out of 21 researches, 15 assessed early preeclampsia, 4 assessed late preeclampsia, 4 assessed both, however 7 articles studies only preeclampsia as an outcome. The extracted estimate show value of first trimester uterine Doppler as a predictor of early and late preeclampsia. Conclusions: The uterine artery Doppler with maternal characteristics is a valuable, noninvasive tool to be used at 11 to 14 weeks as predictor of preeclampsia in the low resource settings where serum markers cannot be available to general population.

Chemotherapy induced peripheral neuropathy is a disabling pain condition resulting from cancer therapy. However, no scientific data available for many herbal drugs which are locally used and evaluating these drugs would be worth to have scientific approach of using them. In this study an indigenous plant called Clerodendrum viscosum leaves have been used to evaluate the effect of plant in vincristine induced peripheral neuropathy in rat model. Vincristine sulfate was administered to Male sprague dawley rats to induce neuropathy. Pain behavior was assessed by Hot plate, Cold plate, sciatic function index and formalin test were also estimated. Animals were sacrificed and the sciatic nerve excised for histopathological studies. The whole preclinical studies revealed that the aforementioned plant extract exhibited less neuronal damage. The study concluded that methanolic extract of Cleodendrum Viscosum leaves can used against chemotherapy induced peripheral neuropathy.

In the making of the United States of America, rights related to life, liberty and pursuit of happiness hits blocs prejudices and society-based realities. Unlike whites, blacks witness cases of highly-ranked socio-economic hardships in settling families, providing the minimum possible for stable households and assuring well-mannered children from one generation to another. Failure to pass on a legacy of well-indicated morals, mores, attitudes and patterns is abundantly highlighted in Fences by August Wilson, with Troy Maxson the main character who definitely misses the point the same way his own father does with consequences on kids, wives and the whole living society. Psychoanalysis and Marxist literary theories help to denote and decode how generations of fathers as bread-winners pass on to extended families, principles for living which members of the same family accept or reject through manners in which they choose to live their own lives: unfulfilled responsibilities and generation gaps at stake.

The study examined the effects of socioeconomic determinants on educational outcomes in Nigeria. This study was done against the backdrop that the education sector of Nigeria has failed to produce quality educational outcomes needed for the growth of the nation’s economy despite enormous works on the topic by most scholars who failed to account for the combination and extent of the effect of infrastructure, ICT, per capita income, and corruption on education outcome in Nigeria. The study was carried out to investigate the effect of infrastructure, ICT, per capita income, and corruption on educational outcomes in Nigeria using time series data covering a period of 21 years (2000- 2020). The study employed the Autoregressive Distributed lag (ARDL) bounds testing approach to ascertain the relevant relationship while the ECM captured the speed of short-run adjustment to long-run equilibrium. The findings reveal that infrastructure and per capita income have a positive effect on education outcomes (with literacy rate as a proxy) in Nigeria with only infrastructure being statistically significant. The study also found that ICT and corruption negatively and insignificantly affect education outcomes in Nigeria. The study, therefore, recommends that emphasis should be shifted from education for all to learning for all, improvement in infrastructure, and incorporation of ICT in education to aid teaching and learning.