Background: The term undifferentiated connective tissue disease (UCTD) is used when people have symptoms and laboratory results suggestive of systemic autoimmune disease, but lack enough characteristics of a well defined connective tissue disease such as systemic lupus erythematosus, scleroderma and rheumatoid arthritis. Disease in patients with undifferentiated CTD most commonly evolve into a specific defined form while others remain unchanged. Methods: This was a prospective study of patients seen in a tertiary rheumatology clinic. The study was done over three years between July 2013 to June 2016. Patients with symptoms and signs suggestive of UCTD were included in the study. Only those with significant titre of antinuclear antibody (ANA) were included. Excluded from the study were patients with definite diagnosis of specific CTD. Socio-demographic characteristics of the patients were documented. Family history of autoimmune diseases and the time of diagnosis of UCTD were also documented. Results: Five hundred and two patients were seen in the rheumatology clinic over a period of 3 years. There were 79 patients diagnosed of connective tissue diseases with a period prevalence of 15.7%. Undifferentiated connective tissue disease constituted 10.1%. There were 4 females and 2 males. Patients were aged from 18 to 64 years, with a mean age of 42±5 years. Three patients presented with lupus-like symptoms. Arthralgia was the leading symptom. ANA was uniformly positive and the patient with positive anti Ro/SSA presented with sicca symptoms. Conclusion: UCTD is not completely rare in our environment. A high index of suspicion is however needed to diagnose them.

The aim of this study was to formulate and evaluate the chemical, functional, microbial and sensory attributes of complementary food from blends of sorghum, pumpkin seed and carrot. Sorghum and pumpkin seeds in the ratio of 70:30 (A), 60:40 (B), respectively were co-fermented aerobically for 24, 48, and 72 h at room temperature (30 oC). In the same ratio as samples (A) and (B), control (C) and (D) were unfermented. Carrots (20% W/W) was added to all the samples. The samples were subjected to chemical, anti-nutritional, functional, microbial and organoleptic properties using standard methods. The protein content of the fermented samples was higher than that of the unfermented samples. Tannins and phytates decreased after fermentation. Microbial counts decreased as fermentation progressed to 72 h. Water and oil absorption capacity, solubility index, bulk density and least gelation concentration were within the acceptable ranges for complementary food. Leucine and Lysine contents were high in all the samples. Histidine, isoleucine and methionine were higher in co-fermented samples than unfermented samples. The carotenoid value in co-fermented mixture was comparable to recommended daily allowance (RDA) for complementary food value for 10–20 months infants. Organoleptically, co-fermented samples scored higher in general acceptability, and unfermented samples scored higher than the co-fermented in terms of colour, aroma and taste. It could be concluded that co-fermented sorghum, pumpkin seed fortified with carrot blend diet had a better nutritional quality than the unfermented counterparts based on the overall findings.

Value-added pharmacy services (VAPS) are not connected with traditional pharmacy activities and do not include services, related to dispensing of medicines and professional consultation. A cross-sectional study that included pharmacists working in the community pharmacies in Bulgaria was carried-out. The pharmacists` attitudes toward VAPS and an implementation of remuneration were studied. The most commonly offered VAPS were blood pressure (BP) measuring with confirmation of 67.4% of the respondents and blood glucose (BG) measuring - 12.9%, but 42.9% of the pharmacists were willing to provide the different VAPS. Most of the respondents (63.5%) did not support the idea of implementation of a fee for BP measuring, but 53.7% considered it is necessary to charge a fee for BG measuring. VAPS are proven to have added value from societal, healthcare and economic point of view, but additional remuneration should be provided.

Introduction: Fine needle aspiration cytology is rapid, virtually non invasive and simple diagnostic procedure .FNAC offers a simple method of diagnosis of neoplastic and non neoplastic lesions of the head and neck. Material and methods: 280 cases of cervical lesions were taken up in the study over a period for 2 years from August 2017 to July 2019. Various staining procedure was done based on the sample. Results: Peak incidence of 90 (32.1%) cases was noted in 21-30 years age group. There were 168 (60%) females among 280. Site wise distribution shows that majority of lesions are from lymph nodes (39.2%). Of which Granulomatous lymphadenitis of Tuberculous etiology of about 60 cases. Discussion and conclusion: FNAC is a procedure which can be carried out as an out-patient procedure with minimal problems. Owing to its accurate diagnostic potential it is proved useful in separating inflammatory, benign and malignant lesions with good certainty.

Now days, research studies have concentrated on complementary (alternate) medicine in treating a large number of infectious and non-infectious diseases, including cancer. The attention of research now shifted towards alternative natural medicine and is being preferred to the toxic effects of the synthetic drugs that are used to treat such diseases. Studies have shown that many natural plant products like amygdalin extracted from apricots and almonds to have shown anticarcinogen effect on many types of cancers including oral cancer. Herein we made an attempt to evaluate the anti-carcinogenic property of Muntingia Calabura proteins against Oral cancer cell lines. Oral cancer cell lines (KB cell line) were used in the present study. The proteins were extracted from Muntingia Calabura roots and the antiproliferative and cytotoxic activity on KB cell line was evaluated using 3-(4,5-dimethylthiazol-2-YL)-2,5-diphenyl tetrazolium bromide assay. The crude proteins of Muntingia Calabura roots showed cytotoxic and anti-proliferative activity on KB cell lines at a maximum efficacy at 100 μg/Ml is about 58% and maximum IC50 value is 52 μg/Ml. The crude proteins of Muntingia Calabura roots effective as an antiproliferative agent, who caused apoptosis in oral cancer cell line.

This research sought to find out the influence of appropriate instructional resources on retention of pupils with disabilities in mainstreamed Primary Schools in Bomet County, Kenya. The challenge that this study sought to address was low retention of Pupils with Disabilities (PWDs) in mainstreamed schools. This study was embedded in Systems Theory by Von Bertalanffy [1]. It adopted survey research design. The target population was 840 teachers. Yamane formula was applied to get a sample size of 278 teachers. Multi-stage sampling procedure was applied. The findings of the study revealed that appropriate instructional resources significantly influenced the retention of PWDs by = 42.1% (p<0.05). The study also reports a positive and statistically significant relationship between appropriate instructional and retention of pupils with disabilities (r = 0.842; p<0.05). The study concludes that appropriate instructional resources positively and significantly influence the retention of pupils with disabilities. Therefore, when appropriate instructional resources are provided, retention of pupils with disabilities increase and conversely, in the absence of these resources, retention of pupils with disabilities will be challenging. The study recommended that appropriate instructional resources such as textbooks, supplementary curriculum support materials, learning devices or aiders including braille kits, printouts, pointers, embossers friendly to pupils with disabilities be supplied to improve their retention in mainstreamed primary schools.

This study focused on organizational core issues and strategic implementation in public tertiary institutions in Nigeria. A survey research design was adopted with mixed instruments of questionnaire and interview; primary data were gathered through the administration of 94 copies of the questionnaire instrument combined with in-depth interviews with 6 administrators of the studied organizations; purposive sampling was used for data collection. Descriptive analytical tools were used to analyze data profile. Inferential statistics, correlation analysis and multiple regression analysis were used to test research hypothesis. The results revealed that the application of strategic management by these institutions is still at its infancy. The study also revealed that organizational issues, namely leadership (Beta=.301, t=3.071, p<0.05) organizational structure (Beta=.213, t=2.766, p<0.05), organizational culture (Beta=.323, t=3.845, p<0.05) and resource allocation (Beta=.233, t=2.427, p<0.05) had significant positive influence on strategic implementation in public tertiary institutions in Nigeria. It was recommended that managements of public tertiary institutions in Nigeria should benchmark the strategic management practices of their peers in the developed economy in guiding their administration; that the capacity of administrators of these institutions be strengthened through relevant exposure and training in strategic management; that in view of the significant positive influence of organizational issues on strategic implementation, these variables should be properly managed to achieve comparative advantage.

Efficient travel in terms of distance, time and cost are the needs of every traveler. Not all travelers always make careful planning before going on a trip and it could be that the trip is done unexpectedly. In order to help travelers to get a well-planned trip, technological utilization is needed so that travelers can easily get the shortest distance on the route. Smaller distances can optimize usage costs and possibly travel time. One of them is the creation of the website-based shortest route search destination search application with a mobile friendly display. The dijkstra algorithm is one of the algorithms for determining the shortest route from one tourist attraction to another. The calculation of the dijkstra algorithm begins with determining the node (point) that will be formed into a graph.

The reality of ideas that sustainsthe intellectual approach of Nawal El Saadawi, inspires a feminine psycho-sociological renaissance. The harmonious and different arrangement of her Islamic feminism introduces within the Muslim patriarchal affective and representative perception, the notion of profaning the sacred and the traditional enclosures. Through this first person narrative, A Daughter of Isis embodies an effective realm of knowledge that goes beyond the sphere of metaphor; in fact, it becomes that feminine voice that establishes the real power and positive to define her being a human. The purpose of this paper remains an attempt to display the implied practical mode of communication, which appears different from the apparent reality of the patriarchal mode, and the manner El Saadawi creates a discourse of reconstruction and a scientific observation of the real. In this method, the deconstructionist approach involved in this discourse introduces an intellection based on a balance of power. Therefore, the result of this article is expected to underline the material possibilities to ensure a socio-cultural revalorization.

This research aims to determine empirically the relationship between exchange rate (USD/IDR), interest rate, inflation and growth gross domestic product with Indonesian Composite Index in the Indonesia Stock Exchange. This research uses data from the official website of Bank Indonesia and Yahoo! Finance in 2008-2018. The analysis technique using VECM method. This research using analysis program Eviews 9. Before the test, data is transformed into natural logarithms.

Background: Haemotological abnormalities were common in patients with HIV infection. The common peripheral blood findings include anemia, thrombocytopenia, leucopenia or pancytopenia. These abnormalities may be attributable to the direct toxic effect of the virus on progenitor cells, ineffective hematopoiesis, opportunistic infections, immune mechanisms and drug reactions. Methods: It was a hospital based observational descriptive study conducted in department of medicine and ART centre at S P medical College Bikaner and associated group of hospital. Results: Leucopenia was seen in 46% cases and thrombocytopenia in 13% of cases. Hemoglobin level below 10gm% was seen in 65%. Mean HB level in HIV patients was 8.32±2.64/dl, total WBC level was 4.27±0.54×103 cells/μl, Absolute lymphocytes level was 0.059±0.023×103 cells/μl and platelet level was 13.29±6.76×103 cells/μL. Conclusion: Hematological abnormalities were common in patients with Acquired Immuno Deficiency Syndrome. Hemoglobin concentration, percentage of neutrophils and lymphocytes were significantly reduced.

Rehabilitation of a patient with moderate attrition after restoring his vertical dimension is a complex procedure. Therefore, the vertical dimension should be assessed in such a case. This clinical report describes the full-mouth rehabilitation of an elderly patient who was clinically monitored for 30 months to evaluate his adaptation to a removable occlusal splint to restore his vertical dimension. Provisional restorations were then cemented to evaluate the aesthetic and functional outcome to the new occlusion for a time period. Metal ceramic prostheses were cemented. The patient’s tolerance to changes in the existing occlusion was confirmed before proceeding to the next steps. During follow-up visits, the patient’s family reported a marked improvement in his facial appearance, dental aesthetics, speech articulation, and social life.

Internet addiction has gradually become a serious issue in public health worldwide. Especially college students are vulnerable to developing dependence on the Internet, more than most other segments of the society. Hence the present was intended to assess the internet addiction and dietary habits and also to find association between internet addiction and dietary habits among college students. A cross-sectional questionnaire survey was conducted amongst 5 colleges of Coorg district. Data was collected on a semi constructed, close ended, structured questionnaire consisting socio-demographic information, questions on Internet addiction (10) and dietary habits (6). Collected Data was coded and fed in SPSS for analysis. A total of 300 students (19.86 ± 0.94 years) were included. When the scores were tabulated, 46.1% mildly addicted, 47.2% moderately addicted and 6.6% severely addicted to internet. 20.3% occasionally found it difficult to stay away from net for several days. 26.7% of participants always lost sleep due to late night log-ins. Among severe internet addicts, 17.6% eat more when they are anxious, worried or tense (p= 0.001). 64.7% often snack more in the evening (p= 0.006) and 58.8% of severe internet addicts took longer time to eat dinner (p = 0.006). In the current study, internet usage had an adverse impact on the college students in terms of difficulty in staying away from net for several days, losing sleep and to certain extent on dietary habits too. Hence it is necessary to increase the public awareness regarding internet addiction and its impact on dietary habits.

The head face, temporomandibular joint, and the maxillary and the mandibular muscles consist of the trigeminal system and hence the pain is more prevalent in these structures. The orofacial pain affects the patient’s quality of life dramatically. In order to manage the orofacial pain disorders, the clinician need to be familiar with different types of etiologies and characteristics of facial region. In order to attain safe and best therapeutic results, the trigeminal system plays a significant role. It is a cross-sectional descriptive study aimed at evaluation of prevalence and characteristics of dental orofacial pain. The Diagnostic Criteria of Temporomandibular Disorders (DC/TMD) questionnaire was disseminated online, limiting participants to those who resided in Saudi Arabia. A total of 226 participants completed the survey. Axis I related disorders were diagnosed in 195 patients, whereas Axis II related disorders were diagnosed in 36 of patients. This study showed high prevalence rate and an immense range in pain intensity with commensurate and often significant impact on the quality of life. The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/ TMD), has been widely used globally to estimate prevalences of TMD. Additional research is necessary to establish comprehensive classification schemes for all patients with orofacial pain.

To remove the inter-proximal plague, flossing has received the most attention among all the dentists. However, difficulty in dental flossing has made this technique to be avoided during tooth brushing. The proper transfer of Information and motivation to use dental floss and brush can change the attitude of the patient from an unhealthy approach to a healthy approach. The main aim of this study is to assess the knowledge and awareness of the adult population in Saudi Arabia about dental flossing. The pre-designed, pre-tested, and self-administered questionnaire survey was conducted among the adult patients visiting the various clinics in Saudi Arabia. The data that was collected from the questionnaire were analysed using the computer software Statistical package for social sciences that is SPSS 16. Among these 1011 patients, most of them were in the age group ranging from 19 to 25 years. About 971 (55%) participants used toothbrush and toothpaste to clean their teeth, while 234 (23%) patients used mouthwash, and 177 (17%) used miswak. Only 140 (14%) participants used the dental floss, 566 (56%) didn't use dental floss, and 305 (30%) rarely use dental floss.