Objectives: To assess the feasibility of self mouth examination (SME) in case finding of oral cancers and potentially malignant disorders (OPMD) among high risk rural population in India. Materials and methods: 15,000 pretested pictorial handout (brochure) with instructions (local language) depicting the signs of oral cancer and self mouth examination procedures were distributed among every households (n= 3500), People were also demonstrated self mouth examination (SME) technique. One week later a three day cancer detection camp was carried out. Individuals were instructed to conduct self mouth examination (SME) and report the cancer detection camp if any questionable lesions were noticed. Individuals who reported were screened for oral cancer with the use of toluidine blue vital staining, oral exfoliative cytology and final diagnosis through biopsy. Results: The total population consisted on 579 individuals out of which 372 (64.25%) were males and 207 (35.75) were females. The total percentage of self mouth examination (SME) performance was 95.34%. 53.20% of the study population identified suspicious lesions in the oral cavity. After thorough oral examination, malignant lesions like oral cancer (2 cases) and many cases of oral potentially malignant disorders were found. The sensitivity of mouth self examination was 48.66% where as the specificity was 44.75%. The positive predictive value was 23.54% where as the negative predictive value was 71.37%. Conclusions: Self mouth examination is an effective tool which can be used in the case finding of oral cancers and oral potentially malignant disorders.

Aims: Include determining the prevalence of hypertension in UPTH from January 2017 to December 2019, to describe the risk factors associated with hypertension, to describe the demographic distribution of patients with hypertension and to determine the outcome of hypertension in UPTH. Study design: The study is a descriptive cross-sectional study. Place and Duration of Study: The research was carried out at the University of Port Harcourt Teaching Hospital between January and June, 2020. Methodology: A multi-stage random sampling method was used in selecting the records of all patients admitted to the medical wards of the UPTH (between January 2017 – December 2019), with essential hypertension. The first stage involved the use of disproportionate sampling method (where each of the years, 2017-2019 constituted a stratum) to select all the hypertensive cases admitted in each of the years. Simple random sampling was then used in the second stage to select 70 samples from each year, to make up the 210 sample size. This was generated through the use of random numbers. The data were analyzed manually by sorting, tallying and collated into data sheet. Both descriptive and inferential statistics were used to analyze the data. Results: There were a total of 3,200 medical admissions during the period under review (2017-2019), and the prevalence of hypertension was 16.8% (537).The records of 210 (6.6%) hypertensive patients were reviewed and analyzed. There were 109 (51.9%) males and 101 (48.1%) females with a male: female predilection of 1.1:1. The mean age was 55.7 ± 4.5 years with a mode of 62 years. Urban dwellers were 63.3% while 36.7% were rural dwellers. Also, 57.1% of these patients were in social class V (unskilled workers, farmers, traders and housewives); and only 2.9% in social class I (professionals). More so, chronic alcohol intake accounted for 16.7% of the admitted cases, followed by diabetes mellitus with 12.4%.Smoking and obesity were 1.9% each. Heart failure was the commonest complication of hypertension (39.5%), while stroke was the commonest cause of fatality (25.0%). Conclusion: Hypertension is an important health problem in the world over. Hence emphasis should be placed on the primary prevention of hypertension through intensive campaigns on lifestyle modifications and regular blood pressure checks. In addition, efficient record keeping and the establishment of a stroke registry would help in the management of hypertension.

Introduction: Abnormal uterine bleeding (AUB) is the most common reason for gynecological visits for perimenopausal bleeding and may account for more than 25% of all hysterectomies. The perimenopause is often characterized by irregularities in the menstrual cycle in volume and frequency. This is due to fluctuating estrogen levels. These changes are unique for each woman and are unpredictable. Although irregular bleeding patterns are normal and expected to be part of perimenopause, the incidence of uterine pathology and associated medical complications increase in this age group [3]. The more accurate diagnosis of endometrial pathology better the chances for alternative treatment and hysterectomies could be avoided. The accuracy or the superiority of the relatively non-invasive methods like TVS, Hysteroscopy, and SIS over histopathology have not been clearly established. Thus this study was undertaken to compare the diagnostic efficiency of TVS over the histopathology study of the endometrium and to test their agreement. Materials & Methods: 48 cases of perimenopausal women above 40 yrs. age not yet attained menopause. Patient with AUB in any other age group, any vaginal or cervical cause of bleeding, Patient with blood dyscrasias, Pregnancy related causes of bleeding, Patient with h/o of drug intake (Anticoagulant & hormone replacement therapy) has been excluded. The cases were studied for a period of 11 months in Noble hospital & research Centre. Detailed history & clinical examination including per vaginal and per speculum examination carried out. All the patient then subjected to transvaginal ultrasound & endometrial sampling. Results were correlated between transvaginal ultrasound & histopathology in these patients. Results: In this study, 72.4% of women with normal endometrium had an endometrial thickness of less than 12mm below which there was no endometrial pathology. Above this cut off level of 12mm, 88.6 % were found to be associated with endometrial pathology. The sensitivity and specificity were found to be 61.9% and 77.8%. Distribution of histopathology findings differ significantly between groups of cases with less than 12mm and more than 12 mm endometrial thickness (P-value < 0.048). Conclusion: Transvaginal sonogram is a simple, non-invasive convenient way to indirectly visualize the endometrium & endometrial cavity. The vaginal probe examination if incorporated into the gynecologist office setting and when combined with bimanual pelvic examination can enhance our anatomic diagnosis. Transvaginal sonography is useful as a first step diagnostic procedure in the evaluation of perimenopausal bleeding. When combined with dilatation and curettage it can supplement the shortcomings of dilatation and curettage.

Cervical ectopic pregnancy is a rare form of ectopic pregnancy with implantation of fertilized ovum in the cervical canal below the internal os. Incidence of cervical pregnancy varies 1:1000-95000 and associated with high maternal morbidity and mortality due to high chances of pregnancy being misdiagnosed. To reduce maternal mortality, it is indeed necessary to understand the importance of correct diagnosis by clinical or radiological or biochemical methods available. Here we present a case of a 36-year-old female reported to us in Noble hospital as a misdiagnosed case of cervical ectopic pregnancy with catastrophic bleeding. Management of the cervical ectopic pregnancy is dependent on several factors such as the patient's gestational age, fetal cardiac activity, stability of the patient, patient's interest in retaining future fertility, and the availability of resources and expertise of the practicing gynaecologist. The cervical ectopic pregnancies though rare, do occur, and their incidence is increasing. A high index of suspicion, clinical and radiological correlation, especially in cases with previous uterine scars can pick up this rare entity preoperatively. If diagnosed early conservative management can be offered. However, missed diagnosis can lead to high morbidity and mortality.

Background: Clomiphene citrate is an orally active nonsteroidal triphenylethylene derivative, commonly used for ovarian stimulation; it is an ovulation inductor, an important tool in various assisted reproduction treatments. The side effects are unusual however they are listed in the OHSS ovarian hyperstimulation syndrome, which is an exaggerated response to excess hormones that can lead to significant complications. Case presentation: This is a case is about a unilateral adnexal torsion secondary to clomiphene citrate’s stimulation, without associated pregnancy which was managed in our department of gynecology in the maternity of Rabat. Conclusion: The ovarian hyperstimulation syndrome is becoming more common as the number of women undergoing in vitro fertilization increases. A worsening of the symptoms of OHS can still normally be managed in outpatient form, but can also have serious complications resulting from are much less common and can involve risk to life.

Background and Objectives: There is increasing evidence that mitochondrial dysfunction and oxidative stress may be central to both chronic periodontitis and type 2 diabetes mellitus pathogenesis. HSP 60 is a mitochondrial stress protein believed to be caused by mitochondrial dysfunction. The aim of this research was therefore to test the salivary and circulatory expression of HSP 60 in periodontitis patients. Methods: A total of 30 patients aged 35-50 were chosen and classified into two groups; (1) Healthy controls; (2) Chronic periodontitis and systemically healthy. HSP 60 in serum and saliva was estimated using a specific ELISA kit and correlated with periodontal parameters using statistical tests. Results: The serum and salivary levels of heat shock proteins were significantly higher in chronic periodontitis patients compared to healthy controls. Conclusion: Salivary levels of HSP 60 can be used as a biomarker to determine periodontitis severity. Patients with chronic periodontitis had higher salivary HSP 60 levels.

The aim of orthodontic treatment in a bimaxillary protrusion case is to obtain an esthetically pleasing face with harmonious soft tissue profile, stable occlusion and pleasant smile. The etiology of bimaxillary protrusion is multifactorial involving both genetic and environmental causes like mouth breathing, tongue and lip habits and tongue volume. The following case report is management of class I bimaxillary protrusion malocclusion in a hyperdivergent case with extraction of all first premolars. The effective management of space without losing anchorage is itself a big challenge. the results produced a pleasant facial profile with attainment of good occlusion. The case required extraction of 1st premolars for correction of the proclined, forwardly placed and crowded upper and lower anterior teeth. Clinical and cephalometric evaluation revealed skeletal Class I pattern and clinical examination revealed presence of an orthognathic facial profile, a vertical growth pattern, increased overjet and average overbite, crowding in maxillary and mandibular anterior region, potentially incompetent lips, increased lip fullness and lip strain, a gummy smile with an unaesthetic smile arc and a decreased nasolabial angle. Following fixed orthodontic treatment by removal of all 1st premolars and with retraction of anterior segment, a marked improvement in patient's smile, facial profile and occlusion was achieved and there was a remarkable increase in the patient's confidence and quality of life. The profile changes and treatment results were demonstrated with proper case selection and good patient cooperation with fixed appliance therapy.

Rugae patterns are used in forensic investigations, owing to its uniqueness. In severely deceased burn victims, palatal rugae aid in identification process due to the resistance of hard palate. However changes in rugae form seen in diseases or trauma are intense in nature to alter identification process. Studies focusing on the effects of growth, tooth loss, or its combination are very few. Hence, the present study was carried out to determine the influence of tooth loss following extraction on rugae pattern in dentulous maxillary arch. A total of 25 patients with completely or partially dentulous maxillary arch indicated for extraction were selected based on inclusion and exclusion criteria. Following consent, Impressions of maxillary arch of patients were made using irreversible hydrocolloid material, and a cast was poured. The procedure was repeated over a period of 6 months after extraction and the rugae patterns traced every month were compared with the previous cast. All the observations were subjected to statistical evaluation. Based on the rugae pattern it was observed that line (mean 1.0 ± S.D 1.22), curved (1.3 ± 1.37) and sinnous (1.9 ± 1.56) patterns were predominant while circular, interrupted and trifurcated rugae patterns were less common. Though the frequency of circular rugae was low; conversely, it showed a high statistically significant difference between post-extraction follow up (P<0.001*) in their mean followed by Line and bi-furcated rugae pattern. We conclude that rugae patterns are not always consistent, as they are susceptible to changes during extractions that can alter substantial identification process.

Cancer is re-unowned by production of neoplastic cells. In cancer, un-developed cells are produced by bone marrow. After their entry into the blood normal cells are un-able to produce and cause anemia. Several oncogenes, including the p53, c-fms and Ras genes, can be activated by point mutations that change the amino acid sequence in the critical portion of protein. L-asparaginase is an enzyme which, by hydrolysis, produces aspartic acid and ammonia. It is used as medicine and in the food industry. It acts as a chemo-therapeutic agent to diagnose the ALL and lymphoproliferative syndrome. The level of Asparagine reduced in plasma decreases the formation of Deoxy ribonucleic acid and Ribonucleic acid. In ALL, asparaginase used in chemotherapy medicines for dealing the patients. it donates the important development in therapy results and helps achieve reform sullener approximately 90% of patients.

Transverse deficiencies should be a priority in orthodontic treatment, and should be corrected as soon as diagnosed, to restore the correct transverse relationship between maxilla and mandible and, consequently, normal maxillary growth. Corrections may be performed at the skeletal level, by opening the midpalatal suture, or by dentoalveolar expansion. The choice of a treatment alternative depends on certain factors, such as age, sex, degree of maxillary hypoplasia and maturation of the midpalatal suture. Thus, the present case report discusses rapid palatal expansion to correct maxillary hypoplasia in a female patient with advanced skeletal maturation and bilateral cross-bite with constricted maxilla.

Job satisfaction is an essential element for the maintenance of the workforce numbers of any organization. Lack of job satisfaction for employees not only leads to high turnover rates but could also have detrimental effects on the individual, like burnout. Turnover provides the organization with new ideas and is a normal process. However, it does not need to be unnecessary and excessive. A high turnover rate leads to the inability of an organization to provide quality care and job satisfaction to employees. Turnover has a cyclic nature and remains a challenging issue. An organization should identify whether turnover is voluntary or involuntary. If the organization has high rates of involuntary turnover, then careful examination of recruitment, selection, training and motivation strategies are important. If turnover is voluntary, then the organization needs to look at factors that influence nurses to leave namely: intrinsic and extrinsic factors according to Herzberg’s theory. The extrinsic factors are conditions surrounding the job and intrinsic factors are relating directly to the job. A study in Jordan, which studied private hospitals’ nurses’ levels of job satisfaction, concluded that nurses in private hospitals reported higher levels of job satisfaction and higher intentions to stay at their jobs than nurses who did not work in private hospitals. This probably indicates that nurses’ levels of job satisfaction are directly related to nurse turnover rates. Nurses in the private hospitals who had intrinsic job satisfaction, had lower turnover rates.

Wannan bincike da aka aiwatar a kan Maƙwabtakar Hausawa ya mayar da hankali ne ga duban irin tunanin Bahaushe dangane da abin da maƙwabtakarsa ta ƙunsa wanda ake tunanin ya ƙara bambanta shi da saura al’ummu na duniya. An gudanar da nazarin ne domin duniya ta fahimci cewa, zaman muhallin Hausawa kusa da juna yana ƙunshe da wasu hikimomi da tanade-tanade da suke da alaƙa da kyakkyawar rayuwar mutanen. A ƙoƙarin tattara bayanan da suka gina wannan maƙala an nazarci irin cuɗanyar da Hausawa suka yi da juna a birane da ƙauyuka musamman a dauri ta yadda zai bayar da hoton ainihin abin da maƙwabtakarsu ta ƙunsa. Haka kuma an yi mu’amala da mutanen da suka fahimci zamantakewar Hausawa da hikimomin da ta ƙunsa. An bibiyi yadda zamantakewar Hausawa take a yanzu a wasu sassa na birane da ƙauyuka inda ake ganin har yanzu akwai wannan tunani a zukatan mutane. A ƙarshen wannan nazari an fahinci cewa, Bahaushe yana ɗaukar maƙwabcinsa kamar ɗan’uwansa na jini. Abubuwan da Bahaushe ya ɗauka maƙwabtakar su ne taimakon juna da kyakkyawar fata a tsakanin mutanen da muhallansu suke kusa da juna. Wannan tunani na Hausawa an fahimci bai tsaya ga magidantan da suka mallaki muhallin ba. Hatta da matan aure da yara ƙanana suna tafiya a kan wannan tunani da kuma tsari. Binciken ya tabbatar da maƙwabtakar Hausawa ta ƙunshi ɗabi’a mai kyau wadda ta taimaka musu wajen samar da zaman lafiya da rayuwa mai inganci.

Hidradenitis suppurativa (HS) is a chronic and painful skin disease. In addition, HS lesions may be associated with pus and odor, potentially leading to significant stigma. Our patient is a 33 year old single man with previous diagnosis of hidradenitis suppurativa since childhood and now is suffering from depression and anxiety. The patient mention follow clonazepam and cigarette use his discharge are declined. As role of stress and anxiety in inflammation, it is possible that benzodiazepine drug and cigarette smoking reduce inflammation and related secretion.

Background: Head and neck squamous cell cancer” (HNSCC) is a term collectively describes the malignant tumours of oral cavity, pharynx and larynx. Globally, the total burden of HNSCC is estimated to be around 22 millions and males outnumber females by 4.1 to 2. Folate Metabolic pathway is complex and crucial process that contributes to folate levels and DNA methylation. The genes behind the enzymes in the pathway are polymorphic in nature and a specific combination of genetic variants may implicates differential susceptibility to different cancers. Methylenetetrahydrofolate reductase (MTHFR), a key enzyme for intracellular folate homeostasis and metabolism provides methyl groups for the methylation of homocysteine to methionine. Aim: The present study aimed to identify genetic variants of MTHFR C677T (rs1801133) and MTHFR A1298C (rs1801131) among HNSCC patients and controls, gene – environment interactions in North Coastal Andhra Pradesh. Methods: A total of 220 samples (110 HNSCC patients and 110 controls) were included in the study and genotyping was accomplished by using PCR - RFLP technique and analyzed by SPSS. Results: The chi square p values revealed that MTHFR (C677T) polymorphism has association with HNSCC and MTHFR (A1298C) polymorphism does not shows association with HNSCC. For MTHFR (C677T) polymorphism, the odds ratio p value of TT genotype and CC genotype of MTHFR (A1298C) was found to be statistically significant. Conclusions: In conclusion, the MTHFR C677T (rs1801133) polymorphism shows association and A1298C (rs1801131) polymorphism does not shows association with HNSCC.

The torque will be big according to the differantial to crank in crank and linkage mechanism by Lagrange formula. That may be fitted to the stroke ratio well. The bigger the one is the bigger the torque is. The crank force is the biggest in this study. The linkage force may incline as the crank mass and linkage length is big. The torque will be big when the stroke ratio is big and the crank mass is inclining on the crank linkage mechanism in vehicle. The force and torque effective turn is Crank angle q3 > linkage angle q2 > piston angle q1>piston displacement s. The torque turn in one status is piston M1> crank M3>linkage M2.