Oral submucous fibrosis is a chronic debilitating disease associated with restricted mouth opening and poor oral hygiene. The treatment aims at good release of fibrosis and to provide long term results in terms of mouth opening. With the increasingly widespread application of reliable microvascular free tissue transfer techniques for oral cavity reconstruction, the routine need for a variety of local and regional flaps has decreased. Various local grafts have been used to cover the buccal mucosal defects after the fibrotic bands are released in oral submucous fibrosis. Successful use of inferiorly based nasolabial flaps in the management of oral submucous fibrosis is projected. In this article, the focus is on the utility of the pedicled nasolabial flap to achieve this goal. Care was taken for post-operative physiotherapy, and was followed up regularly for one year. Flap healed without evidence of infection, dehiscence, or necrosis. The inferiorly based nasolabial “islanded” flaps provide reliable coverage of defects of the buccal mucosa and improves mouth opening

Yawning reflex occurs in many animals and humans. It is believed to be the symbol of tiredness or boredom. It is said to be a contagious phenomenon. Scientific research is limited regarding the causes and purpose of yawning. The present study is planned to determine different yawning patterns in adolescents. After taking informed consent, the questionnaire with 6 point likert scale was given to 76 dental students (66 girls & 10 boys). They were asked to answer accordingly without revealing their identity. The results were represented graphically. Most of the students answered that they yawn “somewhat” or “not at all’. A positive response of yawning “very much” was given by 68.42% of students when they lack sleep. 73.68% & 71.05% students “don’t yawn at all” during an interview and while taking this survey respectively. Yawning is said to be contagious, but only 23.68% replied that they “yawn a lot” while seeing others do it. It can be concluded that the study group is probably alert and active as they expressed their yawning patterns at the base level.

Thrombocytopenia is the term used to denote decreased platelets and it is an important finding in patients with acute illnesses. The presence of thrombocytopenia should prompt the physician to look for the underlying etiology in order to ensure proper therapy. We in the present study tried to evaluate the patients of thrombocytopenia and the causes of thrombocytopenia and treatment. This prospective cross-sectional study was conducted in the Department of General Medicine Prathima Institute of Medical Sciences, Naganoor, Karimnagar. N=112 patients which included n=62 male and n=50 females were included during the study period. A detailed medical history was obtained and complete General physical examination was done in each case. Laboratory investigations were done in all the cases that included complete blood picture, the examination of smears for MP in thick smears, Dengue serology by IgM and IgG ELISA, Liver function tests and Renal functions test. The results showed that the most important cause of thrombocytopenia was Dengue fever in n=47(41.96%) out of n=112 patients followed by Malaria in n=27(24.1%) of patients. The dengue cases were diagnosed with dengue serology the results showed that most of the patients n=35(74.47%) of total cases were having IgM positive and IgG was found to be positive in n=9(19.15%) of cases. total of n=27 cases diagnosed with malaria. Out of the n=27 most common type of malaria parasite which was found to be Plasmodium vivax in n=16(59.29%) of cases and P.falciparum in n=8 (2963%) of cases and mixed was found in n=3(11.11%) of cases. thrombocytopenia is a common laboratory finding in febrile patients. Finding the underlying etiology is very important. In this study, two important causative factors for thrombocytopenia were dengue and malaria. Blood transfusion is to be considered when there is spontaneous bleeding present and the count is below 10,000. Keywords: Thrombocytopenia, clinical study

This is a prospective, unmasked and interventional study. The 207 premature babies were examined for incidence of retinopathy of prematurity (ROP), foetal and maternal risk factors to design an effective screening program for ROP. Further, the efficacy of the modes of treatment were evaluated. Preterm neonates with birth weight ≤ 1500 grams and/or gestation age ≤ 32 weeks; and selected patients with birth weight between 1500 to 2000 grams, or gestational age > 32 weeks but ≤ 35 weeks with unstable clinical course were included in the study. The incidence of any stage of ROP in this study was 21.26%. Majority of patients (84.1%) with ROP developed mild forms of ROP (stage 1 and 2) without plus disease and regressed spontaneous during observation. On univariate analysis, the significant risk factors predisposing to ROP were low gestation age, low birth weight, respiratory distress, unmonitored oxygen supplementation, sepsis, blood transfusion, surfactant use and metabolic acidosis. Maternal risk factor was pregnancy induced hypertension. On multivariate analysis, unmonitored oxygen exposure was the only independent risk factor for ROP. The 15.9% of ROP cases required treatment, and the majority were treated with Diode laser photocoagulation to avascular retina. Intravitreal Bevacizumab was used in 2 cases of AP-ROP in zone 1. Retinopathy in all the five patients regressed.

Abnormal Uterine Bleeding (AUB) is a very common presenting symptom in the Gynecology department in all age groups. It is very significant in peri and postmenopausal age group because of the risk of malignancy is higher as the age advances. We in the present study tried to evaluate the clinical and pathological correlations in patients visiting our tertiary care hospital with symptoms of AUB. Methods: This Prospective cross-sectional study was conducted in the Department of Obstetrics and Gynecology, Prathima Institute of Medical Sciences [PIMS], Nagnoor, Karimnagar. N=60 patients that were included for the study. In the follow up n=7 patients were lost hence there was the n=53 number of patients who were included in this study. All the patients underwent the detailed history and complete clinical examination, required investigations like hysteroscopy, USG, computerized tomography (CT scan) and histopathological examinations were performed for the specimen from endometrial biopsy, D&C, cervical biopsy, or hysterectomy with or without salphingoophrectomy for the diagnosis in this study. Results: In the present study the most common pathological diagnosis was fibroids n=17 (32.07%), Dysfunctional uterine bleeding and Adenomyosis in n=8 (15.09%). Endometrial hyperplasia n=7 (13.20%), carcinoma cervix in n=5 (943%), and carcinoma endometrium in n=3 (5.66%), Endometrial metaplasia, endometrial polyps, and infections were found in n=1 cases each total n=3 included in the others. Similarly, the diagnosis of DUB was made in n=8 cases out of which n=5 were in the age group 40 - 45 years, n=2 in the age group 46 – 50 years and n=1 in the age group 51-55 years. Endometrial hyperplasia was found the total of n=7 cases out of which n=4 were in the age group 40 - 45 years, n=1 in the age group 46 – 50 years and n=2 in the age group 52 - 55 years the other distribution of cases according to age group. Conclusion: The patients presenting with AUB in peri and postmenopausal age group should be comprehensively analyzed including history, clinical examination, USG, and pathological examination. Benign lesions of endometrium and myometrium were the most common causes of AUB in our study. The incidences of cancers were greater with advancing age in this study

This observational study was carried out in the department of Paediatric Medicine and NICU of Dhaka Shishu Hospital during the period of July’2015 to June’2017. The main objective of this study was to observe the Significance of ECG changes in different stages of birth asphyxia and its correlation with Cardiac Troponin-I. A total of 75 neonates diagnosed as perinatal asphyxia with different stages of Hypoxic Ischemic Encephalopathy. Among the total 75 cases, ECG changes were seen in 32(42.66%) patients, remaining 43 babies had no change in ECG. Maximum changes were noticed among the cases with HIE stage-III 21(28.00%), followed by HIE stage-II 10(13.33%) and Stage-I 1(1.33%). Most common type of ECG abnormality was Grade-II changes which was present in 16 patients. This was followed by Grade-III type of changes, found in 9 patients and Grade-I type seen in 7 patients. No significant difference was seen among the neonates with HIE Stage-I, HIE stage-II and HIE stage-III groups with respect to parameters like birth weight, sex, gestational age, crown heel length (CHL), occipital frontal circumference (OFC), maternal age, and antenatal complications. Measurement of serum cardiac troponin I and determination of Myocardial performance index (Tei index), both are effective in assessment of myocardial dysfunction in asphyxiated neonates with HIE. Pearson’s Correlation Coefficient (r) test was done to see whether the two methods correlate in diagnosing myocardial dysfunction. Thorough clinical examination done with special attention to heart rate, blood pressure, and capillary refill time at admission and followed up till discharge or death. Blood pressure (systolic) was measured by auscultatory or flush method and plotted on blood pressure chart, capillary refill time (CRT) assessed by giving pressure over the sternum.

The present study was conducted on 600 Haryanvi adults comprising of 300 males and 300 females aged 18 to 40 years. Prior written consent was obtained from subjects. Inclusion and exclusion criteria for the study were predefined. Two cephalic measurements, maximum head length and maximum head breadth were taken by using standard anthropometric instruments. From the study it was concluded that the mean head length was 18.80 cm in males and 17.85 cm in females. So all the measurements were more in males as compared to females. The head length frequency showed that 58% males and 21.33% females have very long head length, 24.33% males and 56% females have long, 16% males and 24% females have medium, 0.66% males and 7.33% females have short and 1% males and 2.66% females have very short head length. Head breadth frequency showed that 79% males and 76.33% females have very narrow, 17% males and 19.33% females have narrow and 3.33% and 4.33% females have medium head breadth.

Muscular echinococcosis represents only 1-4% of hydatidoses [4], and can take the appearance of a soft tissue tumor. We report the case of a 62-year-old patient hospitalized in our formation for Gluteal hydatid cyst with intra pelvic extension: a rare localization

This paper analyses the driving for the emission reduction performance of industrial wastewater from 2008 to 2017 in Beijing, Tianjin and Hebei by utilizing the modified Kaya identity and the Logarithmic Mean Divisia Index (LMDI) method. As a result, we find that industrial water-saving technology and water consumption per unit of industrial GDP are the negative inhibitors of industrial wastewater discharge, while worker productivity and the scale of workers are the positive factors for industrial wastewater discharge. This study also shows that although the performance of industrial wastewater reduction in this area has improved in the last ten years, there is still room for improvement.

In 2009, the U.S. National Institutes of Health (NIH), now led by geneticist Francis Collins, inspired by the success of this human genoma project, announced the project to discover the human connectome. The connectome refers to the interconnected network of neurons in the human brain. In relation to the methods of the project the organizers the Connectome project's scientists explain that they is using a combination of non-invasive imaging technologies, being the main the nuclear magnetic resonance. It should be emphasized that NIH only mentions noninvasive technology to reach your utopic objective, however this NIH's objective contrast to the existing capacity of the current non-invasive technology. Recent researches give evidences that Human Connectome Project would be carried out based on illegal human experiments performed in university and hospitals of Latin America with invasive neurotechnology such as brain nanobots. The main evidences are: The discovery of nanomafias, the discovery of mafia of cerebral internet, the own declarations of NIH's scientists and the discovery of other NIH's brain mapping projects illicitly with brain nanobots such as BRAIN initiative. In the world, there is a long history of antiethical human experimentation developed by economic powers, projects that are promoted as licit, but that over time a hidden illicit human experimentation is discovered, Human Connectome Project is one of them

Sugarcane flowering is a blessing in subtropical and temperate areas. It is intricate process subjected to a complex interaction of physiological and environmental facets chiefly plant maturity, photoperiod and temperature. Though at Murree, later two (environmental) parameters vary to bit extent from optimum, even then flowering does occur among good number of lines. Almost 41% of the lines grown during this study period flowered to different degree at 400m altitude. Lines were categorized as early (early November to July, 20 lines), intermediate (March to July, 45 lines) and late flowering (May to July, 21lines). Late flowering lines have relatively defined flowering period of 6 to 8 weeks. For sugarcane to flower, minimum physiological maturity is observed to be achieved when plant is about 75 days old or has developed 3 to 4 naked internodes. Shortening day length from 12h 30min to 12h was achieved in second week of September at 120 second per day. Average minimum temperature of (12.2oC) prevailed during flower initiation which was much below optimum requirement of 22oC. Low temperature resulted in variation in flowering among genotypes and was also responsible for reduced fuzz viability. Present study was conducted to ascertain factors responsible for sugarcane flowering at particular site. It will also help to plan future hybridization program in sugarcane.

Discourse analysis is an important approach in interpreting denotations beyond the surface meaning of a sentence. Two methods are embodied in this research to examine the underlying meaning of certain literary texts. Since the novel Anne of Green Gables by Lucy Montgomery still poorly explored, this paper investigates the language of selected contexts of the novel according to the theories of cooperative principle and conversational implicature. To clarify, the research sheds light on the nature of discourse in the novel using Grice's four conversational maxims. The violation of maxims can be explained with regard to the theory of conversational implicature. The findings of this paper demonstrate the efficiency of the applied theories. The results signify that all the maxims have been flouted among the selected parts of the novel. The overall assumption of maxims flouting in this novel is due to the protagonist‟s constant detachment of her real world. Such continuous demeanor indicates the protagonist‟s wishes of escaping her rough cruel life as an orphan and finding a refuge through her imaginative excursions.

Background: Inflammatory fibroid tumor (IFT) is uncommon tumor in large bowl. In this patient it was the unusual cause for large bowel intussusception. More over the coexistence of mucinous adenocarcinoma arising from adenomatous polyp is a rarity previously unreported in the world literature. Case presentation: Here, we present the case of a 65 year old female who complained of lower abdominal pain with rectal bleeding occasionally. Imaging studied confirmed the diagnosis of intussusception of ileocecal type. After resection of intestines, two sessile polyps in caecum were detected. Histology of the polyp’s revealed one showing classical features of IFP and the other a malignant growth arising from tubular adenoma with deep invasion upto serosal coat. Unusually IFP lacks CD 34 stromal cells. Conclusions: Intussusception of ileocecal type due to sessile polyps in caecum is a rare surgical event. The heterogenous nature of these polyps being the cause for this unusual case is previously unreported.

Pediatric solid tumours constitute a unique division of importance not only for the age group affected but also for the increased incidence of recurrence and relapse. OBJECTIVE: The aim of this study is to study the clinicopathological profile of malignant pediatric solid tumours and also to analyze the expression pattern of cancer stem cell marker, CD44 in a series of pediatric solid tumours. Materials and Methods: 75 cases of malignant solid tumours age group less than 17 years, reported at Sri Ramachandra Medical College from jan 2009 to dec 2013 were included in this study. Formalin fixed paraffin embedded tissue stained with H&E were used for routine morphology. Immunohistochemical staining was done using monoclonal anti CD-44 antibody by Streptavidin biotin peroxidase complex technique. Scoring was done using Histochemical Scoring (H-Score) method. Results: Among the 75 cases 52 (68%) were males and 23(32%) were females. 22(29%) were CNS neoplasms and 53(71%) were Non CNS neoplasms which included lymphoma, Ewing’s sarcoma, Osteosarcoma, Wilms tumour, Soft tissue tumours, Germ cell tumours, Neuroblastoma, Hepatoblastoma & others. The CD 44 expression was variable according to the grades of CNS tumours. Among non CNS neoplasms, lymphomas showed an increased expression for CD44 with all the 11 of 12 cases (91%) being positive [Mean H-score- 213.4]. Ewing’s sarcoma/PNET (9 cases) and Wilm’s tumour (5 cases) were completely negative for CD44. Conclusion: Pediatric solid tumours form a wide spectrum. Targeting CD 44 CSCs could be a strategy to improve the outcome in these tumours.

Hemoglobin D Punjab or HbD Los Angeles is one of the commoner hemoglobinopathies. In β-chain there is substitution at position 121 i.e.121 GluGln (Glutamic Acid is replaced by glutamine). The clinical spectrum of all the variants are usually ranges from asymptomatic state to mild hemolytic anemia and mild to moderate splenomegaly. Here, the retrospective study was carried out in general population of all the age groups in Dhiraj General Hospital, Vadodara, Gujarat. The duration of study was 8 months. Diagnosis of HbD Punjab was done by hemoglobin HPLC method with BIO-RAD D-10™ machine. Total 16 Hb D Punjab cases out of 1245 cases were found. Which were further categorized in Hemoglobin D trait (HbAD); Hemoglobin D disease (HbDD); Hemoglobin D-β–thalassemia (thalassemia trait/AD trait or DD homozygous) and Double heterozygous S and D (HbSD) entity. While HPLC reporting, it is very essential to keep these differentials of Hb D Punjab entity in suspected hemoglobinopathies because in today’s scenario there has been change in geographic distribution of population. A collective data from clinical history, complete blood count, HPLC finding & sickling solubility tests enable definitive identification of hemoglobin D Punjab variant.