Most of the physiological processes in the mammals exhibit the circadian rhythms which are guided by endogenous biological clock. This biological clock consists of a central unit which is located in hypothalamic suprachiasmatic nucleus (SCN) and the secondary clocks are located in the peripheral tissues. Circadian rhythms endure 24-hour oscillations of substantial number of the master genes that control the synchronization of varied metabolic and physiological actions within our bodies. This is a very complex regulative network which contributes to an important association between brain and several peripheral tissues as well as organs. The circadian fluctuations of the gene expression are regulated at the molecular level by a family of transcription factors known as “clock genes”. The imbalance or dysregulation in the expression of these clock genes can result in the varied human pathological conditions, inclusive of cancer and autoimmune diseases. The evidences are escalating regarding the effect of circadian clock in the tooth development, homeostasis of the oral epithelium, salivary gland and saliva production. The present article summarizes the available knowledge regarding the roles of the clock genes in the genesis as well as perpetuation of the oral tissues, and also mention about the potential association between the “oral clocks” and the diseases like head and neck cancer as well as Sjögren’s syndrome.

Rheumatoid Arthritis is an autoimmune disorder of unknown etiology. There is no one stop therapy that can cure the disease. The goal of therapy in Rheumatoid arthritis is to induce prolonged remission. Disease Modifying Anti rheumatic Drugs (DMARD) are the drug of choice, can be used either in monotherapy or in combinations of DMARDs. Among all of these DMARD‘s, commonly methotrexate based combined therapy is used to control the disease. Our present study is to evaluate the response of the drug therapy on disease process and compare the efficacy of the two regimens Methotrexate + Lefunamide vs Methotrexate +Sulfasalazine +Hydroxychloroquine using ACR 20 guideline and also to study the adverse event occuring during this study period. It is a prospective observational study carried out in the department of Pharmacology and Rheumatology outpatient department of R.G. Medical College and Hospital, kolkata. Treating physicians prescribed the drugs according to the condition of the patients without any randomization. Patients were divided into two groups, Group A 60 patients who had been prescribed Methotrexate +Leflunomide, 60 patient of another group (Group B) were prescribed Methotrexate+ Sulphasalazine +Hydroxychloroquine. A questionnaire containing 20 questions (HAQ DI) were given to each patient for assessment of Physical Function at baseline and after 6 months to evaluate the response to drug therapy. After completion of therapy data were analysed by proper statistical method and it was found that our study had shown that efficacy of MTX+SSZ+HCQ (group-B) was statistically better improvement than MTX+LEF (group-A) using ACR20 guideline (p=0.031).

Objective: Dorsalis pedis artery represents the continuation of anterior tibial artery distal to level of ankle joint. The dorsalis pedis angiosome encompasses the entire dorsal aspect of foot through its branches eg. Medial tarsal, Lateral tarsal, Arcuate and 1st dorsal metatarsal arteries. Dorsalis pedis artery variation have been reported in past. Evaluation of dorsalis pedis artery pulsation is useful clinical test for assessing peripheral arterial diseases. Dorsalis pedis artery is the main source of blood supply to foot. Knowledge about origins, course, distribution and branching pattern is important for angiographers, vascular surgeons and reconstructive surgeons who operate upon these region. Method: Study of dorsalis pedis artery was done in forty dissected lower limbs of unknown sex and age from department of anatomy, PDUMC, RAJKOT. Result: In our study normal course and branching pattern of dorsalis pedis artery was found in 87.5% cases. Variation in branching pattern of dorsalis pedis artery was found in 12.5% cases. Conclusion: Variable branching pattern of dorsalis pedis artery is common. Therefore, a thorough knowledge of anatomy of dorsalis pedis artery is of prime importance to Radiologists, Surgeons and Anatomist.

This study aims to examine the effectiveness of the implementation Good Corporate Governance (GCG) and financial performance on the quality of sustainability reporting disclosure. The dependent variable used in this study is the quality of sustainability reporting disclosure which is proxied by the G4 Sustainability Reporting Index (SRI), while the independent variable is good corporate governance (the proportion of independent commissioners and audit committee meetings) and the financial ratio dimensions (net profit margin, debt to equity ratio and price earnings ratio). The population in this study are companies listed on the Indonesia Stock Exchange in 2016-2017. The sample in this study was selected using the purposive sampling method and as many as 92 observational samples were obtained. The analysis technique used in this study is multiple linear regression analysis. The results of this study indicate that only the debt to equity ratio variable has a significant effect on the quality of sustainability reporting disclosure while the variable proportion of independent commissioners, audit committee meetings, net profit margins and price earning ratios have an effect but not significantly on sustainability reporting disclosure

Introduction: Mandibular third molar is commonly encountered impacted teeth. The present study aimed to assess relation of mandibular canal wit IANC. Materials & Methods: The present study was conducted on 82 patients with impacted mandibular third molar of both genders requiring surgical extraction. Patients underwent OPG and CBCT. Images thus obtained were analyzed by oral and maxillofacial radiologist followed by classification of Michele. Results: Out of 82 patients, males were 48 and females were 34. Darkening of roots (DR) was seen in 14 males and 10 females, diversion of canal (DC) in 10 males and 6 females, narrowing of canal (NC) in 8 males and 5 females, presence of cortication in 10 males and 7 females and interruption of white line (IWL) in 6 males and 6 females. The difference was significant (P< 0.05). Maximum number of subtype 3A relation was seen followed by subtype 1B, subtype 3A, subtype 3B, subtype 1A, subtype 4B etc. Conclusion: Authors found that impacted mandibular third molar surgery may lead to damage to inferior alveolar canal. Therefore a radiographic imaging with OPG and CBCT may be useful in preventing damage to the nerve.

Background: The most frequent complication which follows the removal of impacted mandibular third molars is ‘dry socket’ or Alveolar Osteitis (AO). The present study aimed to evaluate the incidence, risk factors (age, sex, infection) contributing to the development of dry socket and clinical feature following surgical removal of impacted mandibular third. Material & Methods: The present study was conducted in 86 adult patients requiring surgical extraction of impacted mandibular third molar. The surgery was performed in a standardized technique. Patients were recalled regularly and symptoms and signs of dry socket was noted if developed. Patients were reviewed at 3rd and 7th day of surgery. Results: Out of 86 patients, 46 were males and 40 were females. Out of 46 males, 5 and out of 40 females, 4 developed dry socket. Age group 18-30 had 2 dry socket, 30-50 had 2 and >50 years had 5 cases of dry socket. The difference among both genders was significant in age >50 years (P< 0.05). The incidence of DS was in 7 patients suffering from systemic diseases and 2 medically fit patients developed dry socket. Postoperative symptoms such as pain, empty socket, bare bone and halitosis on 3rd and 7th day. There was significant reduction in symptoms on 7th day. Conclusion: Dry socket is multifactorial in nature. Authors found that higher number of dry socket was in age group >50 years, in males and in patients with systemic diseases. Need of the Study: Assessment of risk factors may be useful in preventing complications arising from mandibular third molar extraction.

The present study assessed the alteration of the liver biochemical enzymes following dermal exposure to petroleum motor spirit (pms) on 25 albino whister rats. 10 served as control while the treated had 15 albino whister rats and clustered into 3 based on the treatment scheme (1ml, 2ml, and 3ml). The serum biochemical assays, body weight, and histopathology of the liver where evaluated. The study revealed the mean of 101.20±2.781 and 111.40±2.591 for weight before and after treatement respectively with a statistically significant (t= -20.821, df= 9, p=<0.05) for control subjects. While the mean of the treated group (PMS) was 116.67±12.199 and 110.33±11.872 for weight before and after treatment correspondingly. The study demonstrated a statistically significant mean difference between the two different weights for pre and post treatment exposure. In analyzing the biochemical assays, the result of treatment with 1ml PMS showed a moderate increase in ALP (11.60±.548) when compared to the control (11.40±0.516), while AST and ALT significantly decreased (192.00±19.170 and 110.80±9.311) when compared to the control (245.40±4.648 and 143.60±13.426) at P<0.05. When treated with 2ml PMS the ALP, AST, ALT (12.60±.548, 298.20±29.029 and 172.80±20.266) all increased when compared to the control (11.40±0.516, 245.40±4.648 and 143.60±13.426) at p<0.05. The mean comparison of the treatment of albino whister rats using 3ml PMS showed a significant increase in ALP and AST (14.00±2.739 and 275.40±30.672) when compared to the control (11.40±0.516 and 245.40±4.648) at p<0.05. But, comparing the obtained result of ALT, result showed a decrease in the level of ALT (118.00±27.386) when compared to control (143.60±13.426). The histopathological examination results as described in the histopathology report shows significant suggestion of deformation in the cell structure of hepatocytes subsequent to treatment with varying doses of PMS. Dermal exposure of these xenobiotics is almost certainl

Aims: Abruptio placenta which is a major cause of maternal morbidity and perinatal mortality globally is of serious concern in the developing world. We retrospectively analysed the abruptio placenta cases and evaluated its impact on maternal and fetal outcomes. Materials and methods: This is a retrospective study conducted in department of Obstetrics and Gynaecology at GGH, KADAPA from April 2018 to June 2019. Patients of abruptio placenta with more than 28 weeks of gestation, presenting with antepartum haemorrhage and their maternal and fetal outcome is evaluated. Results: In our study period we encountered 30 abruptio placenta cases. In 30 patients 11(36%) patients were presented with preeclampsia, 18(60%) patients were multiparous, and almost all the patients were having anaemia. These were considered as risk factors for abruptio placenta. All the cases were referred from nearby PHC to our tertiary care hospital, GGH, KADAPA. In our study 3(10%) patients developed complications, in that 2(6.6%) patients developed Disseminated Intravascular Coagulation (DIC) and 1(3.33%) patient had acute kidney injury and no maternal deaths encountered in our study. Regarding fetal outcome 22(73.33%) patients presented with IUFD by the time of presentation to the hospital and 1(3.33%) stillbirth, 2(6.6%) babies admitted in SNCU and 5(16.66%) were having good Apgar. Conclusion: We observed that higher incidence of anaemia, multiparity and preeclampsia as risk factors in our study population. We need to motivate public regarding the importance of antenatal care, improvement in nutritional status and create awareness about family planning practices. We noticed that early identification and intervention can prevent maternal and perinatal mortality.

HCC is the one of the most common of cancers and now according to world statistics it accounts for fifth most common types of cancer in the world. The mortality is very high and it second leading cancer in terms of cancer-related mortality in the world. The frequency has been on a study rise in the last one or two decades. It is one of the serious malignancies and has one of the worst prognoses in terms of morbidity and mortality. The numbers are expected to increase in the next decade or two as more and more urbanisation and industrialisation are happening thus indirectly leading to life style modifications. Liver is the mainly concerned with the metabolism and it is easily targeted as it is the first line of defence or contact as far as the ingestion is concerned. Toxic environment is one of the most important causes. With increase in the incidence and prevalence of the toxic substances being ingested and also the unhealthy life style followings is being practised, more number of cases is expected to encounter. If global scenario is considered then higher incidence is reported in the developed and industrialised nations. This study puts in an effort to profile the Hepato-Cellular Carcinoma cases.

Heart disease is a major cause of mortality and morbidity in pregnant women. It is reported in 0.2 to 4% of all pregnancies. The incidence of heart disease in pregnancy has increased in the last two decades due to better surgical treatment for congenital heart disease, due to which more number of women are surviving to reach adulthood and opting to conceive and continue pregnancy. Pregnancy is associated with major physiological adaptations in to ensure adequate blood supply to uterus and to ensure blood supply to growing fetus. The net result is increase in cardiac output, plasma volume, heart rate and decrease in systemic vascular resistance. Risk assessment in pregnancy is based on CARPREG scoring system. Patient should be informed about the increased chance of miscarriage, prematurity and fetal growth restriction. If pregnant female is on warfarin it needs to be switched to heparin at pregnancy detection and again at 36 weeks. In general, vaginal delivery is preferred and delivery should occur in tertiary centres with readily available team of cardiologist, anesthetist, senior obstetrician and neonatologist.

Rhinosporidiosis is a chronic granulomatous mucocutaneous infecion caused by Rhinosporidium seeberi. The infection is non-contagious and as the name suggests, it is primarily a disease of the nose. Here, we report a rare case of rhinosporidiosis affecting the nasopharynx in a 35 year old male patient.

Ameloblastomas are bening intraosseous lesions affecting maxillary jaws. They originate from the epithelium involved with the formation of teeth such as enamel, odontogenic rests of Malassez, reduced enamel epithelium and odontogenic cyst lining. Thus, the hypothesis of transformation of a dentigerous cyst into an ameloblastoma was suggested in the literature. These lesions are locally invasive and can grow to infiltrate soft tissues. The risk of recurrence after surgical treatment is important and a long term survey is indicated. The aim of this paper is to demonstrate the diagnostic dilemma in front of a well-defined radiolucent lesion of the mandibule associated to an impacted wisdom tooth and the diffuclties on therapeutic decision. A healthy 34-year-old man referred to our dentistry department complaining about the recurrence of inflammatory episodes associated with tooth number 48. The radiological examination showed a large well limited radiolucent lesion related to tooth number 48, situated in the ramus region. The patient underwent tooth extraction and cystic enucleation. The anatomopathological examination confirmed the diagnosis of a follicular ameloblastoma. Nevertheless, the cystic wall showed both a detigerous cystic portion in one part and a follicular ameloblastoma segment in another part, confirming the hypothesis of ameloblastoma transformation of a detnigerous cyst.

Bushke-Lowenstein Tumor Giant or Condyloma Acuminata is a rare neoplasm induced by an oncogenic human papilloma virus (HPV 11 and 6). It is a sexually transmitted disease. Despite of its indolent character it can probably degenerate to an aggressif epidermoid carcinoma like in our observation. We report the case of a patient who developed this tumor with locoregional destruction .The Aim of this work is to describe this pathology via a literature review.

Background: Child abuse is a serious problem causing physical, social and psychosocial harm to the children. Aim: To evaluate the effect of educational protocol in improving mothers’ knowledge, practice and attitude about child abuse. Design: A quasi-experimental research design [pretest -posttest] was used. Setting: At the out patient’s clinics at Zagazig University Hospitals. Sample: A purposive sample consisted of 100 mothers participated in this study and they were chosen according to inclusion criteria. Tools: Four tools were used; Interview questionnaire sheet, Mother's knowledge about child abuse, Child Abuse Prevention Attitude Scale, Check List for Expressed Practices on Child Abuse. Results: Revealed that most of the mothers were secondary education, house wives and from rural areas, there were statistical significant differences between pre\posttests regarding knowledge, practice, attitudes for the mothers regarding child abuse and there was negative association among the incidence of child abuse and the level of knowledge, practice, and attitude of their mothers. Conclusion: The applying of educational protocol for mothers was effective in enhancing their knowledge, practice, and attitudes regarding child abuse. Recommendation: Educational pamphlets about child abuse and its prevention strategies should be given to mothers in different settings such as, clinics, worksites and health care centers, and also establishing child abuse prevention programs at schools could be helpful.

Background: The major source of blood supply to long bones is by nutrient arteries in phases of ossification as well as during growth period Aim: to study the nutrient foramina of human femora and its surgical significance. Materials and Methods: 114 Dry femora (Right: 58, Left: 56) were collected from under graduate medical students and from the Department of Anatomy, Kurnool Medical College, Andhra Pradesh to study the morphometry of the nutrient foramina of human femora and its surgical significance. All the femur bones observed for number of nutrient foramen (NF) and location of nutrient foramen in the present study. The total length of each bone and distance of nutrient foramen from the proximal end of the bone was measured by using Osteometric board. Results: We noted 56 bones with single nutrient foramen on right femur bones, 2 bones noted with double nutrient foramen and also noted 55 bones with nutrient foramen on its linea aspera, 3 bones with nutrient foramen on its lateral surface out of 58 right femur bones in the present study. We noted 53 bones with single nutrient foramen on left femur bones, 3 bones noted with double nutrient foramen and also noted 52 bones with nutrient foramen on its linea aspera, 3 bones with nutrient foramen on its lateral surface, 1 bone with nutrient foramen on its medial surface out of 56 left femur bones in the present study. Conclusion: Variations in nutrient foramina is of great importance in understanding the blood supply of the femur bone for surgical procedures.