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.

Introduction: Tuberculosis is one of the major causes of mortality and morbidity in childhood. It is challenging to diagnose in childhood population due to difficulty in collection of sample and paucibacillary nature. Despite of considering mycobacterium culture as gold-standard test, it is time consuming (4-8 weeks) while traditional ZN stain is poorly sensitive or specific. In 2013, WHO endorsed Cartridge Based Nucleic Acid Amplification Test (CBNAAT) for diagnosis of TB. Still, there is lack of adequate research on TB detection efficacy of CBNAAT over ZN stain or culture. Aims & Objective: Comparison of CBNAAT over ZN stain & mycobacterium culture, in terms of Sensitivity, Specificity, Positive Predictive Value, Negative predictive value. Materials & Methods: Total of 565 patients admitted to Paediatric Medicine department over 2 years from July 2017 to July 2019 with clinical signs (radiological) and symptoms of local & disseminated tuberculosis and history of close contact were selected and grouped under pulmonary and extra-pulmonary categories. Each sample was analyzed by CBNAAT, ZN smear and culture.

Nanotechnology has proven to be a boon to entire field of dentistry. This review article provides update about nanotechnology in orthodontics and various treatment modalities available with newer technology especially in field of dentistry.

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.

Family planning services are important for the health of mothers and babies, Family planning services are important for the health of mothers and babies, preventing both unwanted pregnancies and superfecundity. Sanliurfa has the highest fertility rate in Turkey, and the rate of giving birth at very young and old ages and mother-baby deaths are also high there. Therefore, it is important to encourage access to and use of family planning services among men in Sanliurfa, which has a patriarchal societal structure. This study aimed to determine the knowledge, opinions, and behaviors regarding FP methods among married men living in Sanliurfa, Turkey. The sample of this cross-sectional study included 300 married men aged over 18. The study found that married men living in Sanliurfa had a high level of knowledge about family planning methods; however, their use of family planning methods was low. They also held the opinion that men should actively take part in the use of family planning methods. Language and social insurance were found to be the most important factors affecting men’s use of family planning methods.

Water for human consumption may contain pollutants, so it needs to be treated. A natural clay, Bildet Omar bentonite (southern Algeria), was purified and characterized by calcination, pH-metry, IR, XRD and SEM. The results obtained showed that the clay has a conductance of 66.4 μS, a cation exchange capacity (CEC) of 0.91 meq / g and contains 12% of organic matter. Characterizations by IR, XRD and SEM showed that Maghnia bentonite (B) is composed of quartz as major impurity, illite (7%) and mainly montmorillonite. This clay was saturated with sodium (Na +) and associated with iron (III), aluminum (III) and copper (II). The latter are inserted, by couple (Al-Cu, Fe-Cu and Fe-Al, 50 - 50% in atoms), in the inter-sheet space of the soda montmorillonite. The mass ratio metals / B is equal to 0.0625. The samples obtained are applied to fix the organic matter (MO) wastewater, very heavy, the city of Touggourt (southeastern Algeria). These organic materials represent 60% of suspended matter (MES). This work involves the study of urban wastewater treatment in the Touggourt town by natural processes. Water is used red and green clay from the region of Bildet Omar, it shows the importance of effective treatment of wastewater by clay. The results obtained show that: • The best clarification is achieved with the use of clay • Parallel treatment significantly reduces organic matter. • The use of yellow clay leads to a better elimination of turbidity and organic matter.

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.

Introduction: Fine needle aspiration cytology (FNAC) has become popular as a valuable tool in preoperative assessment of breast masses, helping the clinician to plan appropriate management. It is a rapid, simple, cost - effective procedure with minimal complications. Aims and Objectives: 1) To assess distribution pattern of non-malignant breast lesions. 2) To evaluate diagnostic accuracy of FNAC with cytohistological correlation. Materials and Method: Cross-sectional descriptive study with the use of secondary data was done for 2 years, including all the non-neoplastic and benign neoplastic cases where FNAC on breast lumps was performed in the department of Pathology, SDM College of Medical Sciences, Dharwad, Karnataka, India. Cases where the aspirate were acellular or hemorrhagic and malignant breast neoplasms were excluded from the study. FNAC slides were collected from the departmental archive and were reviewed. Results: Of the total 339 cases, 11 (5.60%) were males and 328 (94.39%) were females. Age group ranged from 10 to 70 years. Fibroadenoma was the most common lesion (72.27%). 98 cases were followed up with biopsy, out of which 95 cases were concordant and 3 were discordant. Diagnostic accuracy of FNAC was found to be 96.93%. Conclusion: The most common benign breast lesion was found to be fibroadenoma. Discordance rate of FNAC was 3.06%. Hence, FNAC is a valuable tool in the evaluation of non-malignant breast lesions.

Globally cervical cancers affect about 15% of the women and are the second most common cancer among female population. A dramatic reduction has been observed in the incidence and mortality of cervical cancer after the introduction of Pap test. This study was carried out to assess the role of pap test in cervical cytology and to determine the prevalence of various lesions. This cross sectional study was carried out among 400 patients who attended Gynaecology. Out Patient department. Smears were taken from female patients in the age group of 30-60years with complaints like frothy white discharge, post-coital bleeding, intermenstrual bleeding, dyspaerunia and lower abdominal pain. After fixation in 95% alcohol and staining, each smear was carefully examined. The cytological smears were made by staining under Papanicolaou’s technique and interpreted using new 2001 Bethesda system. Although majority of the smears were negative for any intraepithelial lesion or malignancy, (87.3%), inflammation was present in 69.7% of the smears and 62.5% showed non specifc inflammation. In addition, 28(7.0%) showed candida infection and 1(0.25%) had evidence of Trichomonas infection. Pap test continues to be an essential screening tool to detect early cervical lesions. In addition, it pap test is useful in highlighting the significance of screening test in women of both reproductive and postmenopausal age groups.

Introduction: Ovarian lesions are commonly encountered lesions of diverse morphological spectrum that may develop from neonatal period to post-menopause. They are amongst the most frequent cause of hospitalization and surgery in gynaecological practice. Distinguishing non-neoplastic lesion from a neoplastic lesion on the basis of clinical, radiological or gross characteristics alone is a challenge, thus histopathological examination is must as it is also important in guiding therapy. Objectives: This study was undertaken to study the various histopathological patterns of ovarian lesions, their classification and relative distribution of these lesions. Material and Methods: This is a retrospective study of ovarian lesion specimen that was received in the Histopathology section of our department over a period of 5 years from January 2013 to December 2017. Results: A total of 190 cases of ovarian lesions were included in this study with age range from 14 years to 75 years. 106 were non-neoplastic and 84 were neoplastic in nature. Functional cyst including Corpus luteal cyst was the commonest non-neoplastic lesion (26 cases) followed by 21 cases each of endometriotic cyst and simple cyst. Out of 84 neoplastic lesions, 74 were benign, 3 were Borderline and 7 were malignant in nature. Serous cystadenoma was the commonest benign lesion and Serous carcinoma was the most common malignant tumor in our study. Conclusions: Ovarian lesions comprises of wide spectrum of lesions and their presenting clinical, radiological and gross features are very similar. Hence Histopathology forms the mainstay of definitive diagnosis and categorization of these lesions.

Objectives: To find the prevalence & clinical profile of various benign breast lesions in females presenting with breast lump and to establish its cytohistologic correlation. Methods: A prospective study was conducted in the Department of Pathology, Chirayu Medical College and Hospital, Bhopal [M.P]. A total of 203 patients were diagnosed with benign breast lesions both by Fine Needle Aspiration Cytology and Hisopathology over a period of twenty four months. Data including age, complaints and clinical examination was collected from patients presented for FNAC in Cytology Department with Breast complains. Result: Benign breast lesions are more common in younger age group. Of 203 cases 47.3% belongs to 3rd decade of life (Age 21-30yrs) followed by 31% from 4th decade (31-40). The commonest mode of presentation was Lump in breast in 55.7% cases. The spectrum of lesions were Fibroadenoma 54.2% (n=110), Fibrocystic disease 14.3% (n=29), Fibroadenoma with atypia 3.9% (n=8), Granulomatous mastitis 3.4% (n=7), Breast abscess 4.9% (n=10), Galactocele 2.0% (n=4) and Acute mastitis 3.0% (n=6), Papillary lesion 3.4% (n=7), Phyllodes 2.0% (n=4), Duct ectasia 1% (n=2), Fat necrosis 0.5 % (n=1). Histology was available for 117 cases. No discrepancy was noted. Conclusion: It is essential to diagnose the Breast lesions at the earliest for appropriate management. Diagnosis by FNAC is safe, easy, accurate and economical procedure with easy repeatability, yielding quick results and reducing the need for open biopsies in the reproductive age group. Confirmation of diagnosis by Clinical Examination, FNAC and Histopathology is an important part of diagnostic workup.

Introduction: Group cooperative learning is a new teaching method, which makes the traditional, single and passive teaching methods become new, diverse and active teaching methods, and the teaching contents and teaching process are also from presupposition and closure to generation and openness. Such teaching methods can better cultivate students' innovative spirit and practical ability. This paper introduces the group cooperative learning mode into the teaching of linear algebra class, through teaching practice and investigation and research, we find some problems in the process of advancing, and think positively about these problems, and give effective solutions, which can provide a powerful guarantee for the wide application of group cooperative learning.

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.

Social media are interactive communication platform usually used for community-based inputs, content sharing, interaction and collaboration among people. Prominent social media platforms are, facebook, twitter, google+, wikipedia, LinkedIn etc. These social media channels serve as source of information and influence in decision-making process. Travel experience, photos, videos and other contents shared on social media may influence other prospective tourists in their destination selection decision. This study intended to discover the impact of social media on tourists' decision making. Data have been collected from 167 respondents using judgmental sampling technique. Collected data were analyzed using principle component analysis where 15 variables were reduced to two factors (social media information about destination and social media word-of-mouth). Further, the extent of influence of obtained factors on tourists' destination selection decision was identified using regression analysis and stated that these two factors explains 52.2% of the variance in data.

Small and Medium Scale Enterprises play an important role in the Economic Development of both developed and developing nations. Nigeria is no exception with SMEs providing about 85% of employment in manufacturing sector, believed to contribute to about 70% to GDP and account for about 92% of businesses in Nigeria. However, the SMEs are confronted with challenges of credit accessibility for their expansion and growth. The above constraints gave rise to the researchers to examine impact of bank loan on the profitability of SMEs in Bauchi state of Nigeria. The objective of the study was to examine impact of bank loan on the profitability of SMEs in Bauchi state. To this end, the study used survey method and secondary data method. A self-administered questionnaire was used to obtain relevant data from a sample of 97 SMEs operators of Bauchi state. In addition, Krangcie and Morgan table was used to select the firms. Both descriptive and multiply regression analysis were used in the analysis of the relevant data. The analyses were done using multiple regression analysis to examine impact of bank loan on the profitability of SMEs in Bauchi state. In conclusion, this research shows that bank loan has negative relationship with Return on Asset but have positive relationship with firm size and firm age in Bauchi state based on the research findings.