Multiple myeloma is a malignant hematological neoplasm which, primarily involving the bone marrow, but it has a potent extension towards other organs and to present with various clinical manifestations. Involvement of the stomach presenting with epigastric pain and vomiting is extremely rare. We report a case of a 73-year-old male presented at the Gastroenterology Unit with epigastric pain and uncontrollable vomiting. He was known to have a history of multiple myéloma and had previously been treated with a very good partial response. The patient underwent esogastroduodenoscopy witch revealed nodular gastritis without ulceration. Histopathological and immunological analyses showed diffuse atypical plasma cell infiltration with prominent staining for CD138 of the gastric mucosa. Relapsing multiple myeloma was diagnosed. This case illustrates a very atypical presentation of recurrence multiple myeloma and should be kept in mind in a patients with atypical gastric pain, especially those with a history of hematologic malignancy.

Intestinal parasitic infections have been described as the greatest single globalcause of disease and illness.A survey of prevalence of intestinal parasites among the native Libyan people attending several health centers (governmental and private) in the city of Zawia. The study was designed to cover the period of 2010-2015. Stool tests from 12,850 patients was performed. 8950 specimens of the 12,850 examined were found to be infected with intestinal parasites. The infection rates were 69.6% among the native population. The rate of infection in females (65%) was higher than in males (34.9%). Overall, protozoa infections (92.4%) were higher thanhelminths infections (7.6%). Entamoeba histolytica (60.70%) and Giardia lamblia (31.73%) were the most common intestinal parasites identified. Among the helminths, Ascaris lumbricoides, Trichiuris trichiura and Hymenolepis nana were the frequentones. The high prevalence rate of intestinal parasitic infections among the local Libyan people clearly indicates that there is continuous ongoing transmission of various parasitic infections in the community.

The arrangement of vascular tissues differs in the root and shoots in angiosperms. The root has a solid triarch or tetrarch exarch xylem whereas the stems possess endarch xylem made of individual vascular bundles arranged in a ring form. A continuous flow of water and minerals is not disrupted in spite of this difference in the arrangement of xylem tissue in the two organs. This happens because of a transition region extending from the upper portion of the root, ending in either the hypocotyl or epicotyl where a gradual alteration in the arrangement of the xylem tissue occurs. The aim of the study was to investigate the extent of transition region and the structural anatomy of xylem in the transition region of three tropical legume species viz. Vigna radiata, V. unguiculata (red variety) and Cicer arietinum. Sequential transverse sections from the base of the root, hypocotyl and epicotyl were obtained from five day old seedlings of the three selected legumes, stained with safranin and viewed under the light microscope. Sections were digitally photographed. In all the three species studied, the transition region commenced a few millimeters below the soil surface. In Vigna radiata and Vigna unguiculata it ended in the hypocotyl region above the soil surface whereas in Cicer arietinum it ended in the epicotyl region. The beginning of transition region showed appearance of a pith in the center of the xylem core. Gradual widening of pith resulted in separation of xylem tissue. This was followed by reorientation of exarch to endarch xylem. A variation in the structural anatomy of xylem among the three species was also observed in the length of transition region and structural anatomy of xylem.

Possible Effect of Citrus Limon Juice and Tamoxifen on the Tumour growth mass Indices, Cell Proliferation, Cell Viability and Cytogenetic (Mitotic Index) of Sprague Dawley Rats Induced MCF-7 Breast Cancer Cells was carried using, over one hundred and twenty Sprague dawley rats of 40 days old with average body weight 180-220g were divided into Ten (10) groups with 12 animals per group, group 1 was control, fed only with rat chow and water, group 2 was MCF-7 cell line induced Breast cancer rat alone (BCIR only), group 3 Citrus limon juice (CLJ) at 8.88%, Group 4 Citrus limon juicen (CLJ) at 17.32%, group 5 Citrus limon juice (CLJ) at 25.98%, group 6 was given 0.2mg/kg of Tamoxifen alone, group 7 (BCIR+ CLJ at 8.88%), group 8 (BCIR+ CLJ at 17.32%), group 9 (BCIR+CLJ at 25.98%) and group (BCIR+ 0.2mg/kg of Tamoxifen). Acute and sub – acute toxicity were carried out after the establishment of safety dose following determination of LD50, on the fresh Citrus limon juice, Tumour growth mass Indices were carrying out on weekly basis on the experimental rats, on completion of the administration of the treatments, animals were sacrificed, Blood was collected into Plain and hepariniced bottles simultaneously for Cytogenetic (Mitotic Index) analysis, Tumour tissues were also extracted, passaged and cells were cultured and analysed for Cell Proliferation and Cell Viability assays. Microscopically, it was revealed that DMSO at 1.5% was highly toxic to the MCF-7 cells and other components of media, meanwhile the Citrus limon juice at 8.88%, 17.32% and 25.98% showed minimum cell growth inhibition of MCF-7 cell lines and permit cell viability at 40%, 25% and 10% respectively without any effect on the media components. In conclusion, this study showed that Citrus limon juice posses anticancer activities and does not pose pathological conditions on the body during and after usage, hence it could be used as alternative therapy in the treatment of Breast cancer that are hormonal dependant in similar manner to Tamoxifen.

Ovarian pregnancy accounts for 2 to 3% of ectopic pregnancies. It is independent of other usual extra uterine pregnancy risk factors. Its physiopathology remains unclear; it can evolve until the second trimester or even term. The diagnosis is difficult; it is often made perioperatively and confirmed by histology. Despite the progress of medical treatment, surgery remains the best way for therapeutic management. We report a case of paucisymptomatic ovarian pregnancy successfully managed at the Moroccan Military Field Hospital in the Zaatari Camp with a literature review

Hepatitis E is due to hepatitis E virus which causes the inflammation of the liver. It is the most common type of the virus among hepatitis A, B, C and D. Hepatitis E is virus that cause the millions of the infection in year. It is more acute in the pregnant women. It is so lethal and dangerous for those women. Hepatitis E is virus that is the major cause of the illness and is a reason of the major disproportionation of the death especially in the pregnant women. Hepatitis E is a most common types among all the types of the hepatitis A, B, C and D. It is mostly found in the Asia, Northern and Central Africa. There are the many reason through which it spreads. There are the many treatments are available for hepatitis E. But some are the use of the clean water. Use the food that is clean and there is no contamination in the food.

A new field of biomedical science, known as tissue engineering, applies the principles of biology and engineering to the development of functional substitutes for tissues and organs. The influence of Keratinised Mucosa dimension around implants on the soft and hard tissue health. The purpose of this case report is to understand the importance of healthy tissue around the implants for long term success and how biomimetic materials like PRF Membrane can be incorporated in treatment plan as an important modality in selected cases.

The purpose of this study was to investigate the relationship between the Big Five personality traits and Machiavellianism on Malaysian and international university students. The sample population consisted of 755 students (352 international and 403 local students) that were selected through multi-phase clustering at a Malaysian university. The instruments used were the NEO Five-Factor Inventory (NEO FFI), Mack IV, and General Health Questionnaire (GHQ). Data was analysed by means of two-way ANOVA, correlation analysis, and regression analysis. The outcome of the two-way ANOVA showed that neuroticism, agreeableness, and overall mental health and its subscale were significantly different between male and female students. A strong correlation was found between mental health, neuroticism, and Machiavellianism in both groups. According to the regression analysis, neuroticism held the highest effect on students’ mental health in both groups.

Core needle biopsy (CNB) is a part of triple assessment for preoperative evaluation and diagnosis of breast cancer as it can distinguish benign and malignant lesion, insitu and invasive cancers. In addition to its primary role in establishing histologically diagnosis it can provide prognostic information like grade and type of tumor which can influence initial therapeutic decisions. We present the result of 80 patients of palpable breast lesion who underwent for core needle biopsy followed by therapeutic surgical excision. Diagnosis of lesion along with histological typing and grading of invasive carcinoma were determined in both core needle biopsy and excision and the result compared. We observed 83.2% agreement for histological typing. There was 66 % agreement with overall grade (kappa K value-0.56),71.2% for tubule formation score 66.6% for nuclear pleomorphism,55% for mitoses (component of Bloom Richardson grading).Only 45cases of grade 1 shows concordance but 80% of grade 3 cases show concordance between CNB and surgical excision. This result is of important clinical relevance as these are the patients potentially most likely to benefit from neoadjuvant therapy. The Major problem with assessing of grading of tumor on CNB is due to under sampling of most representative areas. Hence quadrant wise sampling with increase of attempts in different directions and assistance of image guidance would improve the accuracy of CNB.

Background & objectives: Polycystic ovary syndrome (PCOS) is the most common disorder of ovarian pathology in women of reproductive age group Insulin resistance and hyperinsulinemia may play an important role in pathophysiology of PCOS. To estimate fasting plasma glucose, plasma insulin levels, insulin resistance and lipid profile in obese and non obese female infertile women with PCOS. To study the association between insulin resistance, lipid profile and obesity in female infertility in PCOS. Methods: 30 obese infertile women diagnosed by ultrasonogram as PCOS and with a BMI> 30Kg/m2attending Gynecology OPD at Narayana medical college and hospital were taken as cases. 30 age matched non obese infertile women with a BMI<30Kg/ m2 were taken as controls. Results: In our study the fasting glucose, fasting plasma insulin values and insulin resistance was significantly elevated among cases when compared to controls (P value <0.001). The Mean ± S.D values of LDL cholesterol were elevated in cases when compared to controls (P value <0.001). Interpretation & conclusions: This clearly shows the importance of screening for dyslipidemia and insulin resistance in Indian Women with PCOS. Hence periodic monitoring of lipid profile and B.P specially for obese PCOS patients may be advised.

Multilocular cystic renal cell carcinoma recently has been excluded from clear cell renal cell carcinoma (ccRCC) category and re-designated as multilocular cystic renal neoplasm of low malignant potential (MCRNLMP) and represents an extremely rare renal entity comprising <2% of all renal carcinoma and bears a low malignant potential which benefits either with simple nephrectomy or nephron sparing surgery. The pathologists need to be more cautious in diagnosing this rare entity as it mimics other diseases having reasonable prognosis. We herein report a case of MCRNLMP in an elderly patients with non-specific symptoms of 6 months duration, having a renal mass in the lower pole of the left kidney seen on computerized tomography. The final diagnosis of MCRNLMP was rendered after thorough histological and immune-histochemical evaluation. The patient was discharged after uneventful post-op duration and put up on regular follow up.

The impression materials are essential for the fabrication of stone casts and dies. The successful impression is based on the accuracy of impression material with respect to detailed reproduction and dimensional accuracy Differences in dimensional stability, wettability, and surface hardness are seen among various elastomeric impression materials. The purpose of repouring elastomeric impression material is to evaluate the accuracy of the material between different time intervals. At two different time interval with different types of die, stones poured for vinyl siloxanther elastomeric impression and additional silicone for the study to evaluate the dimensional accuracy material. The poor reproducibility, lack of surface details, and bubbles in the cast, which may lead to an inaccurate die and a poorly fitting prosthesis due to poor incompatible materials. Method: The study involves as per American dental association specification, using a stainless steel die nearly 90 impressions were taken, out of which 45 impressions were taken by each impression material, by pouring into 3 different die stones and equally subdivided into groups of 15 each. The statistical analysis was used for ANOVA test and TUKEY' POST – HOC TEST. A Computerized coordinated measuring system was used to assess various dimensions on stone cast poured from the impression of the stainless steel model. Group A, B, C: Indentium Medium poured with Ultrarock, Elite rock, Alpenrock. Group D, E, F: Monopren Transfer poured with Ultrarock, Elite rock, Alpenrock. Results: The result shows that Addition silicone yielded less accurate cast than formulated identium (vinyl siloxane ether). Conclusion: The study concluded that presence of a certain amount of variation at a time interval (15 min and 75 min) on impression repouring, henceforth indicates that when poured immediately better accuracy is seen, and newly formulated vinyl siloxane impression material yields more accurate impressions

Maxillectomy is one of the most common procedures performed by oral and maxillofacial surgeon. Various classification systems exist in literature to describe the surgical defect, left behind after maxillectomy. Success in Maxillofacial defects depends on the principles of facial harmony, retention, durability, tissue compatibility & tolerance. The Velopharynx is tridimensional muscular valve located between the oral and nasal cavities, consisting of lateral and posterior pharyngeal walls and the soft palate & controls the passage of air. Cleft palate is the most common cause of velopharyngeal insufficiency. Velopharyngeal insufficiency may take place when the velopharyngeal valve is unable to perform its own closing, due to lack of tissue or lack of proper movement. Treatment options include surgical correction, prosthetic rehabilitation & speech therapy; though optimal results often require a multidisciplinary approach for the restoration of anatomical and physiological defects. This article is a case report of the treatment procedure done for a young patient with cleft palate and velopharyngeal insufficiency.

Objective: The clinical characteristics and experience of rural Indian children of West Bengal with paraquat poisoning – a retro prospective analysis. Methods: The study: From June 2014 through April 2019, fourteen children with paraquat poisoning who presented to the hospital were enrolled .The collected clinical indices of these cases were and analyzed. Results: oral ingestion of paraquat were found in most of the children and the commonest route of poisoning. Different degrees of damage were found in multiple systems in their bodies. Initial therapy consists of removing the paraquat from the body (decontamination) and preventing further absorption for oral exposures by using activated charcoal followed by pulse therapy using methylprednisolone (20 mg/kg/d×3d) and Gamma globulin (total 2 g/kg divided into 3 d to 5 d)for all children in the early stage. Prednisone was then given orally for 4wk to 8 wk. The total mortality rate of the patients was 64.8% (09 of 14 patients died). Statistical differences (P<0.05) were found between the surviving and dead patients, with regard to age, plasma paraquat levels, the highest levels of alanine aminotransferase, aspartate aminotransferase, γ-glutamyl transferase, total bilirubin, direct bilirubin, indirect bilirubin, blood urea nitrogen,creatinine and pH value, the lowest levels of PaO2, PaCO2 and SaO2. Plasma paraquat level was positively related to pH value, but was negatively related to PaO2, PaCO2 and SaO2 levels. Hepatic and renal complications are encountered in admitted patients but the patients survived.However the fibrosis of the lung is one of the dreaded complications in the long run. Conclusions: There is no cure for Paraquat poisoning. In this study, pulmonary fibrosis was the primary cause of death.Treatment by administering pulse doses of methyl prednisolone and Gamma globulin seems to be effective in the early stage. However, the treatment may not reverse the development of pulmonary fibrosis. The long-term prognosis of paraquat poisoning was not optimistic.For predicting the prognosis, plasma paraquat level is significant.

Background: The posts selection and cementation helps to bond with restorative material. Hence, post retention is responsible for long span survival of endodontically restored teeth. The technique and selection of cement selected for cementation will determine the bearing effect of the post retention. Aim: The purpose of the study, evaluate and compare using 3 different techniques about the carbon fibre post push out bond strength at the coronal, middle and apical levels of extracted mandible tooth of single root. Methodology: The premolars extracted were selected about 50 and based on the technique using lentulo-spiral instrument, to the surface post, with the support of elongation tip the material was injected and divided into 3 groups the post space drilled using rely-x light polymerized. In the acrylic resin the root specimens embedded and sectioned and finally measured using Universal testing machine. The overall effort is to subject for the bond strength push out. The failure bond strength specimens were studied and evaluated using operating microscopes. Result: The Elongation tip method as well as lentulo-spiral method p (value 0.052 and 0.0089). Conclusion: Using three techniques Post hoc analysis was done to find out stress bearing capacity at coronal middle and apical levels. The comparison between lentulo-spirals and direct method, the study results such as nil difference in stress bearing capacity.