Cleft lip and palate are the utmost typical facial deformity. It may occupy lip only, lip and palate and palate only. The primary deduction of clefting in infants may be each environmental or genetic aspects (such as familial factors and chromosomes). The amount of professionals involves in management of clefting and decides the highest treatment plan depending on the site of deficiency and period of the infant. Aim: The principle of the current paper is to present the etiology of cleft lip and cleft palate mutually the genetic and the environmental aspects. It is optional that the genetic basis for dissimilar kinds of familiar or unusual congenital malformations may marvelously be homogeneous, even as, the ecological basis is heterogeneous. Etiology: The etiology of CLP looks multifaceted, with genetics playing a vital function. Numerous genes create syndromic CLP have been exposed. Three of them, T-box transcription factor-22, poliovirus receptor-like-1, and interferon regulatory factor-6 are accountable for generate X-linked cleft palate, cleft lip/palate-ectodermal dysplasia syndrome, and Vander Woude and popliteal pterygium syndromes, correspondingly; they are also occupied in nonsyndromic CLP. Conclusion: To terminate, while the etiology of nonsyndromic CLP is still mostly unidentified, mutations in applicant genes have been known in a tiny amount of cases. Formative the qualified menace of CLP on the basis of hereditary conditions and environmental manipulate (together with smoking, alcohol use, and dietary factors) will be practical for genetic analysis and the expansion of future protective procedures.

This work presents the performance assessment of two industrial gas turbine power plants. The plants are GE M5001 gas turbine and BBC M05864 gas turbine, all operated in Rivers state, Nigeria. The international standard organization (ISO) rating, average operating field data and calculated results of the gas turbine performance parameters were compared. The first law analysis was employed for the calculations, where the exhaust gas temperatures, net power outputs and the thermal efficiencies were estimated. The calculations were done using the pressure ratios obtained from the field for the M5001 turbine, while the ISO value was used for the M05864 turbine. The maximum and minimum power generated as obtained from the field during the period of study are 20.37MW and 19.15MW respectively, obtained at pressure ratios of 8.33 and 7.87 respectively, while the corresponding calculated values are 24.44 MW and 24.17 MW respectively for the M5001 turbine. The corresponding thermal efficiency values calculated are 27.09% and 26.79% respectively. The ISO rating of the turbine is 26.84 MW, the thermal efficiency is 28.4% while the pressure ratio is 10.5. For the M05864 turbine, the ISO pressure ratio of 9.55 was used for the calculations. The calculated power output is 50.196 MW as against the field value of 50 MW. The ISO rating is much higher at 65 MW. There is thus no much difference in the net power output between the field data and the calculated value for the M05864 turbine, but there is significant difference in this parameter for the M5001 turbine. The ISO values are generally higher because the real engines operate at higher ambient temperatures. The comparisons between the calculated values and the field results reveal how well the engines are being operated.

Religious debates today are challenging the very peace and fraternity of society just because the people who actually practice religion are often misguided by those who actually don’t practice any religion. I mean the political parties and politicians. The politics round the globe has hijacked and reinterpreted the basic concepts of religion. The religion was actually established to unite the society and to guide the people to follow a particular series of morals and ideals. Today people have misunderstood Hinduism with ‘Brahmanical religion’. Hinduism or Sanatana Dharma prescribes to live a simple dignified life for the service of humanity and nature. It has no definite set of rules. In the later Vedic age, the Varna system became more complex. The Brahmans created many complex set of rituals to be followed to be called a Hindu. They prescribed to follow different ways to get rid of sin and gain virtue. The Sanatana Dharma or Hinduism gradually was dominated by Brahmanical religion. It’s time to look back to the roots of Hinduism and follow Sanatana dharma. If not, then at least a retrospection must be done to know the difference between Sanatana Dharma and Brahmanical religion.

Business negotiators ask themselves frequently what could be done to better a poor, frustrating deal. This article addressed the question by analyzing N=535 business negotiations outcomes, from which n1 = 265 were held without any preparation (situational negotiations), and n2 = 270 negotiations were mapped and structured before the negotiation starts. Key findings pointed 94 percent agreements on both groups. However, the n2 group performed 12.42 percent better and created approximately 25 percent more options for mutual agreements than n1. Evidence also suggests some negotiators failed in recognizing the underlying interests on the other side of the table, despite defending empathy as one of the crucial qualities to a successful business negotiator. This paper provides scholars with a new perspective and taxonomy on the business negotiations preparation. Implications for managerial practice are discussed, and future research directions are suggested.

Background: Acute coronary syndrome (ACS) refers to a spectrum of symptoms compatible with acute myocardial ischemia. Worldwide acute coronary syndrome (ACS) is one of the main reasons for hospital admission and the leading cause of death. Several risk factors have been identified. However high blood pressure and hypercholesterolemia remain the most important risk factors in (ACS). Objective: To determine the risk factors associated with ACS among patients admitted to the coronary care unit (CCU) in the Military Hospital-Sana’a. Methodology: Study design according to a case-control study. Two groups of patients were included in this study, the first group was cases who have (ACS), and the second group was control cases admitted to CCU for other causes. All data were recorded in a special sheet including demographic, clinical presentation, investigation, and treatment plan. The data was entered into PC and analyzed statistically. Results: There were 124 patients with ACS versus 91 control patients without ACS. The majority of participants in the two groups were males (80 %). Their age ranged from 18 to 95 years old with a mean age of 53.9 ±13.6 years. (86.5 %) of them were 40 years old or above. The significant risk factors associated with ACS were hypertension, Khat chewing found in 71.6 %, 64.4%, of the patients, respectively. Another significant risk factor was dyslipidemia which was higher among ACS patients than the control group with a P-value of < 0.05. Conclusion: Preventing the program from avoiding risk factors that were associated with ACS may decrease the occurring of ACS and reduce the morbidity and mortality in Yemeni patients.

Wilson’s disease is a hereditary disorder of copper metabolism which is characterized by neuropsychiatric and hepatic manifestations as well as appearance of Kayser-Fleischer ring. A male presenting with features of gradually progressive dysphagia, dysarthria, dystonia, abdominal discomfort and difficulty in maintaining balance, was referred for ophthalmic evaluation for any neuro-wilson manifestation. Patient had BCVA of 6/6 both eyes with anterior and posterior segment revealing no significant findings. Slit lamp biomicroscopic examination revealed a yellowish-brown deposits of Kayser Fleischer (KF) Ring following which diagnostic tests for Wilson Disease (WD) were carried out and treated for the same. The dense KF ring conveys that it has been a long-standing disease and a definite indicator of Neuro-wilson disease. This case report emphasize on the significance of early identification of KF ring and its neurological relevance.

The study that deals with the scrutiny of sweat pores is known as Poroscopy. They were located as little openings over the frictional ridge skin near the distal end of digits & in palms and soles. The study was conducted in central India among 400first year MBBS students of both sexes within the age limit of 18 to 23. Thumb prints of left hand were taken with Kores printer's ink over the executive bond paper and are then processed with Ninhydrin chemical. The Latent prints thus obtained are cautiously scrutinized using light source microscope. Prints are observed for number of round shaped pores per 1cm ridge and noted carefully. Images were captured with digital camera. Largest number of round shaped pores per cm ridge on left hand thumb impression were ranging from 2-4 were identified among both the sexes. It has also been observed that males presented highest number of circular or round pores with a range of 2-4 in 1cm ridge as compared to females. Thus the poroscopic study based on the shapes of pores in 1cm ridge of thumb prints plays a significant role in sex determination

In the present study, approaches had been made to study the various fishing gears that are being operated in River Barak and in Katakhal basin. An attempt had been made to document the traditional methods carried out for fishing in those areas, which revealed a total of 10 different types of fishing devices in the form of traps, nets and hooks. The efficacies of the gears were also being studied and it was found that the Gill net, Lift net and Cast net were most efficacious in those two areas.

In this work, polynomial deflection expression was used in the free-vibration investigation of thick rectangular plates with two different boundary conditions; one with its four edges clamped denoted with the acronym (CCCC) and another with two adjacent edges fixed and having simple supports at the other two adjacent edges denoted with the acronym (CCSS). The edge conditions of the various plates were fulfilled and used in generating the stiffness coefficients which were substituted into the analytical equation to obtain the non-dimensional frequency functions for the plates at different span-depth ratio (a/t) and aspect ratio (b/a). It was observed that at the same value of (b/a), there is an increase in the value of the non-dimensional frequency parameter as (a/t) increases. Also, at the same value of (a/t), there is a decrease in the value of the non-dimensional frequency parameter as (b/a) increases. The results obtained for the all edges clamped plate were compared with similar works by other researchers in the literature and were found to follow similar pattern and trend and were quite close.

Background: The social society in Africa and most continents, perceives any girl who gives birth before marriage as a wrong doer. Such a girl is deemed to have negated the traditions. Poor and non-communication between adolescents and their parents or guardians has been implicated in most instances. The scenario is the same in the County of study according to information from the respondents and as alluded to by the County Director of health services. The parents and guardians in the County have been called upon to exercise responsibility over their daughters, encourage them to resume school instead of forcefully marrying them off or rejecting them on the bases of pregnancy. The purpose of this study was to give evidence-based health education in relation to family and social support systems in reducing neonatal morbidity and mortality among neonates born to adolescent mothers in the County Referral hospital. Objective: The objective of this study was to describe the role of family and social support in reducing neonatal morbidity and mortality among neonates born to adolescent mothers. Methods: Setting; the study was carried out at a County referral hospital using a randomized control trial design. The participants were expectant adolescent mothers aged 19 years and below attending the antenatal clinic at the hospital. A sample size of 528 respondents (264 cases and 264 controls) was calculated using Pagano formula and realized using simple randomization. Inclusion criteria: adolescent mother ≤ 19 years, gestation period of 26-34 weeks and resident of the study County for sufficient time follow up. Students, non- Kenyans and mothers with existing co-morbidities were excluded for fear of loss to follow up. Results: Negligence and lack of support, 81% (pv 0.000), lack of community emphasis on neonatal care 77% (pv0.001), lack of value for neonatal health, 78% (pv 0.000), lack of knowledge 60% (pv0.003) and poor socioeconomic status, stigma and rejection 89% (pv0.000) were some of the significant study findings. Conclusion: The poor family and social support played a major role in persistently high neonatal morbidity and mortality in the County.

Epithelial-myoepithelial carcinoma (EMC) is an unusual malignant salivary gland tumor. Little is known about the clinical and biological behavior of EMC. There is no consensus for its treatment. It is considered as a low grade malignant tumor. Whatever, it presents a potential of local recurrence and possibility of metastases. We report a 76-year-old patient who presented an epithelial-myoepithelial carcinoma of parotid gland, treated successfully with wide local resection and adjuvant radiotherapy with no signs of recurrence for 3 years.

American writer Ernest Hemingway’s short story The Killers is a classic literary work. Its unique linguistic charm and vivid characters have attracted scholars from generation to generation to appreciate and study. This paper takes the main characters’ conversations in the classic short story as the research object. Through statistical and analytical study of the conversations violating the Cooperative Principle and the conversational implicature they produce, the research aims to reveal the characters’ personalities and show its profound themes, thus helping readers better understand and appreciate the short story and broadening the application of pragmatic theory in the field of literature.

The purpose of this study was to find out the description of education services based on quality assurance and customer satisfaction of private colleges in Central Sulawesi Province. It was a descriptive research, conducted at private colleges in Central Sulawesi Province. The population of the study was all undergraduate students who were registered and active in the B accredited study program on private colleges in the Regencies/Cities of Central Sulawesi Province in 2017. The variables were the quality of education/learning based on quality assurance and customer satisfaction toward education services in those colleges. The results of the study showed that students' perceptions about the quality of education services obtaining a total average score of 4.01 (good category). Customer satisfaction had a mean value of 4.02, indicates that the educational services provided were felt satisfactory. The quality of education/learning based on quality assurance was perceived well by students, in accordance with the quality standards of accreditation B obtained by study programs. The value or benefits of education/learning services are also good and satisfying so that most students feel trustworthy and loyal to the institutions and study programs of higher education.

Although joint pain can be controlled with various modalities which includes the use of acetaminophen, NSAIDs and corticosteroid injections. It has been found that LLLT is an effective non invasive therapy to control inflammation and tissue degeneration and thus to relieve pain with subsequent quality of life improvement in various inflammatory & painful joint problems. Material & Methods: A retrospective analysis was done from the data on osteoarthritis knee patients (n=30) with chronic knee pain, treated with low level laser therapy applied at the knee joint line area over medial & lateral tibiofemoral condyles region. The various parameters like NRS; daily activities, work & leisure, anxiety & depression, social interaction (4 components of DALLAS pain questionnaire as found relevant for these patients to assess quality of life) were studied and analysed using appropriate statistical tools. Results: The majority patients were female (n=17) as against males (n=13). The paired t test revealed that there was significant difference in NRS score before and after laser therapy. The paired t test revealed that there was significant difference with positive improvement in daily activities, work & leisure, Anxiety & depression and social interaction scores before and after laser therapy. Conclusion: LLLT like Helium Neon (He-Le) laser has the potential to be used with efficacy in patients of chronic knee pain due to osteoarthritis irrespective of age and sex, especially in Kellgren lawrence OA grade 1, 2 & 3.

Abdominal tuberculosis accounts for 11% of patients of extra-pulmonary tuberculosis. It is also the sixth most common form of extra-pulmonary tuberculosis. Abdominal tuberculosis that presents without pulmonary or general signs/symptoms of tuberculosis is rare events that occur only in 1.2% of the disease. It can result in an intestinal obstruction; however, it is a rare cause of intestinal obstruction that is usually overlooked or misdiagnosed. We report a 17-year-old female patient who’s not known to have any medical illness presented with acute abdominal pain due to small bowel obstruction with no significant effect on bowel habit. Imaging showed free fluid in the abdomen and small bowel obstruction. The patient was managed surgically with adhesiolysis and started anti-microbial therapy. The report describes the diagnostic challenges that abdominal tuberculosis can presents with, especially in patients without accompanying pulmonary or general tuberculosis signs/symptoms. Such a presentation can be a challenge to diagnosed and usually are mistaken with other differential diagnoses. Therefore, clinicians - especially in areas that are endemic with Tuberculosis - need to consider such rare diagnoses and have a high suspicion of tuberculosis in such a presentation.