Mandibular reconstruction is a complex procedure and is a challenge to the surgeon. Reconstruction is required following resection of mandible due to benign or malignant pathology, osteonecrotic mandible that could not be treated conservatively. Reconstruction modalities have changed significantly over the years with the introduction of newer techniques and technologies. This article reviews and summarizes the various reconstructive modalities for mandibular defects of past years, comparatively newer reconstructive options available and the recent advances in reconstruction done by Patient-Specific Implants produced by virtual planning.

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Background: Albumin is a family of globular proteins, the most common of which are the serum albumins. All the proteins of the albumin family are water-soluble, moderately soluble in concentrated salt solutions, and experience heat denaturation. Albumins are commonly found in blood plasma and differ from other blood proteins in that they are not glycosylated. Substances containing albumins, such as egg white, are called albuminoids. It contributes to the oncotic pressure of plasma and to maintaining the distribution of extracellular fluid between the vascular and extravascular compartments. Hypoalbuminemia is associated with poor tissue healing, decreased collagen synthesis in the surgical wounds or at anastomotic sites [1], and also plays a role in the impairment of immune responses, such as macrophage activation and granuloma formation. Although it is well established that hypoalbuminemia, as a marker of malnutrition and disease, is associated with greater risk of adverse surgical outcome, previous studies have been based on relatively small samples and selected types of operations and have failed to adequately separate the predictive ability of albumin level from other risk factors. Aim of study: To determine whether pre-operative serum albumin level can be used as an independent predictor of post-operative morbidity and mortality. Methods: This is a prospective comparison study conducted in general surgery department, Jubilee Mission Medical College. The source of the data will be all patients who undergo gastrointestinal surgery with resection and anastomosis in the Department of General Surgery, Jubilee Mission Medical College, Thrissur from December 2017 to May 2019. Patients are investigated preoperatively for liver function test, renal function test, thyroid function test and urine- protein creatinine ratio (obtained from urine microscopy) to rule out secondary causes of hypoalbuminemia and are classified into two groups:- normal albumin level and hypoalbuminemia. Patients with normal serum albumin level are compared with patients of low serum albumin for length of hospital stay, resumption of oral diet, surgical site infection and mortality. Results and Discussion: The preoperative albumin levels ranged from 2.1 to 3.4 g/dl with a mean value of 3.03 g/dl. In most other similar studies [1-4], a similar cut off normal range (3 or 3.5 g/dl) was assigned and patients were grouped into two based on this. To explore the possibility of using serum albumin as a simple and low-cost prognostic tool to predict the risk of adverse surgical outcomes, we used different statistical methods. Mann-Whitney U test has been performed to find out the significant role of albumin levels for length of hospital stay (Median 10.5 days and 8 days) and delay in resumption of diet (Median 5days and 3days) among two groups and it showed that there was statistically significant association with albumin levels between two groups in length of stay (p=0.021) if we classify the length of hospital stay as less than 10days and more than 10days. It is statistically significant in resumption of diet (p<0.001). There was a significant relationship found between the occurrence of surgical site infection and albumin levels. Where it was also found that those with low serum albumin had increased rates of complications (60%) against those with normal serum albumin levels 32.5%.15% mortality cases were reported; of which 22.5% falls in low serum albumin level group where as 7.5% in normal albumin level group. Conclusion: In view of these results, we conclude that preoperative albumin is a good prognostic indicator for predicting the outcome of surgery. It is a cheap and easily applicable test. By estimating albumin levels in surgical patients before surgery and adequately correcting lower levels where necessary, post-operative morbidity could be reduced in these patients.

Background: Fine Needle Aspiration Cytology (FNAC) is worldwide accepted, inexpensive, minimally invasive and very accurate method today especially in commonly encountered clinical problems like salivary gland lesions which range from non-neoplastic lesions like inflammation, cysts, and commonest benign tumours like pleomorphic adenoma to malignant lesions of variable malignant potential. FNAC is major diagnostic tool and is of great relevance in head and neck lesions, including major salivary glands as they are easily accessible target sites. The aim of this study was to evaluate spectrum of salivary gland lesions with their clinical presentations and to study the cytomorphological features of various salivary gland lesions, and to evaluate its sensitivity and specificity of FNAC in salivary gland lesions whenever histopathology was available. Material and Methods: A total of 150 cases of salivary gland lesions were analysed both retrospectively and prospectively from January 2010- December 2015 at Department of Pathology, of a tertiary care medical college Hospital. Cyto-histopathological correlation was interpreted wherever available. Results: In the 150 cases thus analysed, the male to female ratio was 1.14:1. Parotid gland was involved in 73.34 %, submandibular gland in 23.33 %, and other minor salivary glands in 3.33% of patients. There were 57.33 % cases of neoplastic lesions and 42.67% cases of non-neoplastic lesions. Chronic sialadenitis (22.67%) was the commonest non neoplastic lesion. Pleomorphic adenoma (40.67%) was the commonest benign neoplasm and Mucoepidermoid carcinoma (9.33%) was the commonest malignant neoplasm. The overall sensitivity, specificity and diagnostic accuracy of FNAC for salivary gland lesions were 93.48 %, 100% and 94.23 %, respectively. Conclusion: Fine-needle aspiration cytology is a very useful diagnostic tool for superficial palpable tumors of salivary glands. It has high rates of sensitivity, specificity, positive predictive value in diagnosing salivary gland lesions and hence a valuable tool in the diagnosis and management of patients.

Heterotopic pancreas is a rare condition with a probable incidence of 1 per 500 upper abdominal operations. Findings are incidental and are usually asymptomatic. Heterotopic pancreas is seen at different sites in the gastrointestinal tract. A 62 year old male presented with complaints of epigastric pain, nausea, vomiting and constipation since 3 months. The diagnosis of malignancy was based upon the findings of abdominal ultrasonography, CECTabdomen and Upper G.I. endoscopy.

Natural products, such as plants extract, either as pure compounds or as standardized extracts, provide unlimited opportunities for new drug discoveries. The research is aimed to investigate the physicochemical properties and characterization of Eucalyptus camaldulensis leaves oil. The physicochemical were evaluated using the standard procedure and the oil was fund to be light yellow color having camphor like smell. The pH of the oil at 22oC was found to be 4.62 while the % oil yield, Optical activity, Refractive index at 27°C, Specific gravity at 27°C, were found to be 49.5±1.021, +34.2°, 1.4384 and 0.812 respectively. The absolute and kinematic viscosity of the leaves oil were 102.30 and 88.20 respectively and the Total acid number (TAN) in mg KOH/g, Iodine number and saponification number were 1.67, 109 and 110.00 respectively. GC-MS revealed the presence of 16 compounds representing 86.96 % of the total oil. The major component was 1,8-cineole (49.08 %), Eucalyptol (34.42) followed by α-pinene (23.90 %), while L-pinocarveol (8.98 %) and globulol (2.71) were the least components. Also α-terpineol, myrtenol, camphene and ciscarveol were present in the oil. The result revealed that Eucalyptus camaldulensis leave oil consist mostly of oxygenated monoterpenes that could be very useful for human, animals and industries, also the oil met the FOA/WHO standard of oils. Therefore, these essential oils could be considered as promising substances for development of new drugs. Hence it potential for medicinal and pharmacological uses.

Impaction is defined by Kuftinec and Shapira as a condition with embedded teeth in socket so that its eruption is prevented and will be locked in that position by either bone or adjacent teeth. Unlike isolated impactions multiple impactions may be due to the underlying syndromes or disorders. In cases where confusion exists in differential diagnosis additional examinations might become necessary to exclude systemic and metabolic disorders.

The utility of Artificial Intelligence (AI) to design is mainly concerned with trying to make systems smarter through getting to know how to enable them to represent and control the real global understanding. It is likewise about contemplating studying how designers observe human intelligence to design, and with looking to make computer aids to design greater knowledgeable. Presently the principle topics inside the utility of Artificial Intelligence are to discover the formal illustration of the layout information, and additionally to expand strategies for reasoning with or applying this expertise. Computers have historically been capable of cope with the application of the legal guidelines of science, expressed in mathematical techniques. Artificial Intelligence (AI) mainly permits illustration of heuristic (or rule based) understanding this is less effortless or simple to explicit the use of mathematical methods. This, a part of artificial intelligence is in particular concerned with the development of such representations is called professional structures or more typically information based totally systems. This paper covers the various steps and ideas involved in adding synthetic Intelligence to the layout of mechanical structures. In this paper, a broad audit with respect to the uses of the Artificial Intelligence, in conjunction with its connection between the mechanical building for the method of mechanical imperfections identification and design layout configuration is proposed. This paper accommodates the précis or synopsis related to the precise utilizations of Artificial Intelligence in the field of mechanical Eng. Several applications, like errors identification, Analytic indicative Framework machine, mechanical shape and structure investigation, and mechanical layout plan are notably inspected. This study uncovers that the Artificial Intelligence based smart system is broadly utilized generally in the total mechanical Engineering designing area. This paper likewise presumes that the Mechanical Engineering and designing field can be effectively combined with different other Artificial Intelligence based innovation era to make it progressively successful to improve in the mechanical framework.

This paper reports the results of an investigation into the use of mobile assisted language learning for learning Arabic as a second language in the context of Saudi Arabian higher education. The purpose of this study was to explore what kinds of mobile learning devices second language Arabic learners and their teachers currently use and how they use these devices for learning the Arabic language. This mixed-methods study employed a sequential explanatory design, incorporating questionnaires and semi-structured interviews with second language students and their teachers. A total of 154 teachers and 492 students participated in the quantitative phase of the study whilst 14 teachers and 16 students took part in the qualitative phase. The results showed that smartphones the most widely used mobile device among second language Arabic learners and their teachers. Their current use of mobile devices was focused on social media apps such as YouTube and WhatsApp to support Arabic language learning.

Pre-eclampsia is one of the common complications of pregnancy and contributes significantly to high maternal and perinatal morbidity and mortality, especially in developing countries like Bangladesh. Objective: The aim of this study is to identify the risk factors and maternal and foetal outcomes of pre-eclampsia patients. Methods and Materials: This descriptive and observational study with data from the Department of Obstetrics and Gynaecology in Sir Salimullah Medical College and Mitford Hospital, Dhaka, during July 2011 to December 2011. Participants 123 pregnant women with pre-eclampsia included in the study. Main outcome measures Identify the risk factors associated with maternal & fetal complications, maternal and perinatal mortality & morbidity and incidence of pre-eclampsia. The patient with particular reference to age, parity, religion, occupation socioeconomic condition, gestational age, rapid weight gain, family history of hypertension and pre-eclampsia, obesity, new paternity, preexisting vascular disease, thrombophilias, previous history of pre-eclampsia, blurring of vision, pain in epigastrium, or pain in right upper quadrant, diabetes mellitus etc. Results: The incidence of pre-eclampsia is 4.3% and majority of the patients was found to be of 3rd decade. More than a half (51.2%) two third of the patient were primigravida. Maximum (65.9%) number was found in the gestational age group of 37 to 40 weeks. Lower abdominal pain 15.4%, Swelling of legs 15.4%, Headache 11.4%, less foetal movement 9.76% and Blurring of vision 8.13%. Mild pre-eclampsia was 44.0% and severe pre-eclampsia 56.0%. Fundal height had corresponded with 29 to 34 weeks in 42.0% patients, presentation was cephalic in 84.0%, fetal heart sounds was audible in 87.8% cases. The mean systolic and diastolic blood pressure was 164.76±9.34 mmHg and 101, 83±8.64 mmHg respectively and all patients had cephalic presentation. Fresh still birth was 3.5%, macerated still birth 1.8%, and Prematurity and IUGR were 7.0%. More than one third (36.4%) was low birth weight and male of female ratio of the babies were 1.1:1. According to APGAR score >7, were 51.5% and 81.8% during 1st and 5th minutes after birth respectively and 16.2% babies received neonatal resuscitation. Conclusion: Pre-eclampsia usually occurs in third trimester, and maternal outcome is better than fetal outcome although the maternal response to the treatment is in positive side.

Subfertility and unconstrained premature birth or unsuccessful labor is two types of conceptive disappointment. Subfertility influences about 10% to 15% of couples. Then again, the danger of fetus removal has been affirmed is about 15% to 20%. The differentiation among essential and auxiliary repetitive pregnancy loss can be made. Essential RPL is depicted as RPL without a past continuous pregnancy past 28 weeks' incubation, while auxiliary RPL is characterized as a scene of RPL after at least one past pregnancies advancing past 28 weeks' development. The main objective of this research is to find out the risk factors of recurrent pregnancy loss. The specific objectives are; to identify the origin of the pregnancy losses, to identify the probable therapeutic targets, and to provide recommendations regarding organization of care for couples faced with RPL. Total 60 samples were selected and the study duration was 3 years. After investigation, it was found that few factors, such as: age, psychological pressure, environmental and occupational exposure, chronic endometritis, smoking, genetic factors, and thrombophilia screening, uterine defects, were some of the risks of RPL. Multiple pregnancy loss can have a noteworthy mental cost for influenced couples, and numerous endeavors are being made to improve medicines and reduction the time expected to accomplish an effective pregnancy.

Introduction: Mitral prosthetic thrombosis (MPV) is a rare but dangerous complication. It is suspected by clinical examination; the diagnosis of MPV is made by trans-thoracic echocardiography and held by the trans-esophageal echocardiography; or a fluoroscopy which shows a lack of prosthesis opening. The treatment is based on the early establishment of anti-coagulation and surgical cure. The thrombolysis is an alternative therapy. Case report: We report the case of a 47-year-old man who undergone a mitroaortic mechanical prosthesis replacement 6 years ago. However, since a year, his INR has been sub therapeutic. He presented a 5 days history of a chest pain and dyspnea. A passing at the intensive care diagnosed a shock according to the cool extremities, sweats, tachypnea and low blood pressure. The ECG showed atrial fibrillation with complete left bundle block. An emergency TTE was performed and revealed a MPV with high transvalvular gradient, while the aortic prosthesis was functional. The left ventricle was dilated and globally hypo contractile; TEE was emergently performed and showed à stuck leaflet caused by thrombus with associated with a thrombus at the left auricle. Patient’s hemodynamic condition required a surgical cure with thrombectomy of the left atrium. Conclusions: Through this case we highlight the interest of echocardiography to diagnose the etiology of shock, and the importance of early management to avoid any complications.

Cerebral palsy is the commonest physical disability in childhood, occurring in 2.0 to 2.5 per 1000 live births [1] Cerebral palsy (CP), a neurodevelopment disorders, is usually associated with abnormalities of pregnancy, particularly 'birth asphyxia' and low birth weight [2]. In the present study all cases were males, mothers were more than 35 years, para4, and uncooked, illiterate and low socio economic status. They all had normal deliveries, were anemic, associated with severe pregnancy induced hypertension, preterm and extremely low birth weight and no genetic overlay Present study 5(0.05%) cases occurred out of 8500 deliveries. Cranial ultrasound imaging can describe patterns of neonatal brain damage in the low birth weight infant that are highly predictive of later cerebral palsy [3, 4].

Oil Exploration in Nigeria has contributed greatly towards pollution of the environment especially in the Niger Delta region of the country where most of the oil wells are located. In the process of their operations which include; drilling, refining transportation etc., oil spillage occurs which pollutes land, air and water bodies. This results to the release of dangerous gases into the air. Properties of soils in the contaminated areas are highly affected leading to poor agricultural produce and alteration of geotechnical properties of soils which may adversely affect engineering construction works. This research work examines the effect of crude oil pollution on the geotechnical properties of clay soil. The clay soil was obtained from Engenni Ahoada L.G.A of Rivers, Nigeria. Soil samples were collected at a depth of approximately 2 meters below the ground surface and artificially polluted with crude oil in the ratio of 0%, 2%, 4%, 6%, 8%, 10%, 12%, and 14% of the dry weight of the soil. The samples were further subjected to various laboratory soil tests to determine their geotechnical properties. The results shows LL, PL, and PI increased from 31%, 20% and 11% at 0% contamination to 56%, 41% and 11% at 14%contamination. SPGR, BD, and MDD decreased from 2.48, 1.33g/cm3 and 1.74g/cm3 at 0% contamination to 1.14, 0.97g/cm3 and 1.35g/cm3 at 14% contamination. OMC increased from 15% at 0% contamination to 16.5% at 14% contamination. Thus, crude oil pollution affects the geotechnical properties of soil greatly.

Dimethyl ether (DME) is used primarily as a propellant and a motor fuel alternative, (DME) is miscible with most organic solvents and has a high solubility in water. Recently, the use of (DME) as a fuel additive for diesel engines has been investigated due to its high volatility (desired for cold starting) and high cetane number of 55–60, with the advantage of high efficiency, and low exhaust emissions (no particulates, no Sulphur, and low NOx). Technical-quality (DME) is an alternative to liquefied petroleum gas (LPG). The production processes included catalytic dehydration of methanol in an adiabatic fixed-bed reactor and two columns product separations. In this study, the technological process for (DME) synthesis is simulated in Aspen Hysys V3.1 based on the combined parameters of the reaction dynamic model for methanol dehydration reaction, the improved NRTL model of the liquid phase, the PR model of vapor phase was selected as the fluid package as it is able to handle selected pure components (methanol, water and dimethyl ether). The equilibrium reaction was selected to describe conversion of methanol to DME reaction and it is about 80%. A feasibility study and design of a plant producing 99.9 wt% Dimethyl ether (DME). The plant is designed which is capable of producing 50,000 metric tons of (DME) per year via the catalytic dehydration of methanol over an acid zeolite catalyst.