Repair of a bilateral cleft lip deformity is challenging yet rewarding. Many surgeons find it hard to achieve results comparable to those of unilateral repairs. Poorly planned surgeries can leave noticeable residual deformities. There is a combination of genetic and environmental factors that may affect development of cleft lip in weeks 4 to 10 of gestation. Bilateral cleft lip and palate is recognized by the presence of a central echodense mass in the region of the upper lip. This mass is known as the premaxillary protrusion and it represents abnormal alveolar and gingival tissue due to uninhibited growth of the premaxilla caused by lack of continuity of the bony, gingival and lip structures. This case report is going to throw light on the unique surgical technique for severly prominent premaxilla in bilateral cleft lip and palate using reductive ostectomy on the vomero-premaxillary suture.

Soft tissue repair following injury can be very challenging for a reconstructive surgeon. The goals of management of facial trauma are the preservation of form and function. The management of facial soft-tissue trauma is particularly critical where injuries can cause not only esthetic deformities but also can affect neural function, normal mastication, visual fields, and salivary outflow. Special consideration must be given to injuries of functional structures such as the facial nerve, ductal systems or organs, and ensuring appropriated management of these structures. This article discusses on few case report and a review of literature pertaining to facial soft tissue injuries.

First trimester sonographic diagnosis traditionally focused on evaluation of growth by serial examination to differentiate normal from abnormal gestations. Current trends in ultrasound late in the first trimester focus on measuring nuchal translucency thickness combined with maternal age and biochemical tests to determine the risk of chromosomal abnormalities and structural anomalies. The objective of the study was to compare normal reference range of mean fetal nuchal translucency (NT) thickness among pregnant women who were coming to the clinic with international reference values. A cross sectional study was conducted in a private ultrasound clinic, Lahore, Pakistan in one year starting from April 2016 to April 2017, after approval from the Institutional Review Committee of the University. A total of 59 pregnant women at 11-14 weeks gestation, were included in this study after taking consent. All NT measurements were performed by a certified sonographer using the Fetal Medicine Foundation (FMF) recommended protocol. Descriptive statistics were presented in the form of range, mean and standard deviation. The mean maternal age and mean gestational age were (27.9 ± 4.4 years) and (11.8 ± 0.8 weeks) respectively. The mean calculated for nuchal translucency thickness, which ranges from (0.6-2.9 mm), is 1.77 mm. This study results show that normal range of NT thickness coincides with the normal range of mean Nuchal translucency found internationally.

This study investigates the link between organisational ergonomics and academic staff performance in federal universities in the South-South zone of Nigeria. It sought to examine the extent of the influences of three organisational ergonomic dimensions (teamwork, job design and effective communication) on the research output- a proxy for academic staff performance. A total of 7,086 academic staff constituted the population of the study. Primary data were collected from a sample of 1,236 respondents that were drawn from the population using the questionnaire. Data obtained were analysed using descriptive statistics, Pearson product moment correlation and multiple linear regression techniques. Results revealed that teamwork had the highest significant level of influence on the research output. This was followed by job design and effective communication. It was therefore concluded that organisational ergonomics has a significant positive influence on the research output of academic staff. Hence, management of Nigerian universities should prioritise the practice of organisational ergonomics and also pay attention to the implementation of policies that would encourage research collaboration among academic staff in their institutions

The aim of this study is to determine the effectiveness of corrugated rubber and tube drains in the management of Ludwig’s angina patients. This retrospective comparative study was designed for patients with Ludwig’s angina that presented to the Department of Oral and Maxillofacial Surgery, University of Benin teaching hospital, Nigeria between June 2008 and July 2018. Data collected from the case notes of the patients were age, gender, type of surgical drain, airway compromise, length of hospital stay, and retreatment. Descriptive and inferential statistics were performed with SPSS Version 17(SPSS Inc, Chicago, USA). All tests were 2-sided and P-Value less than 0.05 was considered statistically significant. Of the 55 patients studied, 32 (57.3%) had plastic tube drains while 23 (42.7%) had corrugated rubber drains. Their ages ranged from 19-72 years with a mean ± SD of 42.1 ± 13.7 years. There was significant higher incidence of airway compromise in patients that had corrugated rubber drains compared to those that had plastic tube drains inserted(P=0.03). However, the type of drain inserted was not an independent predictor of the presence of airway compromise in our patients. There were no significant differences between the two groups as regard retreatment and length of hospital stay. The insertion of open tube drain is as effective as the conventional corrugated rubber drain as it could decrease complications and improve the prognosis for patients with Ludwig’s angina.

A recent issue on Analytical Chemistry laboratory teaching has been on the inability to conduct individual experimentation due to large class sizes and the inadequacy of reagents and equipment in school laboratories. Questions are focused on whether learners develop understanding and attitude when they are not physically involved in physical manipulations. To contribute to this topic, this study exhausted literature involving inquiry demonstration on students’ understanding and attitude. Empirical studies showed that inquiry demonstration enhances students’ understanding and attitude compared to the traditional lecture. However, laboratory work has an advantage in terms of technical and manipulative skills. Throughout the years role-playing, video recordings, and virtual laboratories have been explored in Analytical Chemistry, but there had been no study with the use of inquiry demonstration in this field. This paper suggests that inquiry demonstration is a promising approach with the nature of Analytical Chemistry laboratory and to address the issue of inability to do laboratory work

Background: Many patients diagnosed with autoimmune connective tissue disease cannot be categorised easily into one of the established clinical entities such as systemic lupus erythematosus, dermatomyositis, or systemic sclerosis. The term overlap syndrome is used to identify such patient and is useful in terms of clarifying prognosis and facilitating disease management. Methods: This was a retrospective study of the patients diagnosed with connective tissue diseases. The study was done among patients attending the outpatient clinic of a teaching hospital in the South Western Nigeria. The study spanned from July 2013 to June 2016. Data on clinical characteristics, diagnosis, age at onset of disease, and gender were extracted from their files. Results: Five hundred and two patients attended the rheumatology outpatient clinic over the study period. There were 41(8.2%) cases of connective tissue disease. Systemic lupus erythematosus constituted 29.3%, undifferentiated connective tissue disease 19.5%, and scleroderma 14.6%. Others were secondary Sjogren's syndrome 14.6% and overlap syndrome 7.3%. There were 3 overlap syndromes and all were females. A case of rheumatoid arthritis/systemic lupus erythematosus (RA/SLE), SLE/polymyositis, and Scleroderma/Polymyositis. Patients were aged 18 to 64 years, and the mean age was 42±5 years. Female constituted 85.4% of the total population with a female to male ratio of 5.8:1. Conclusion: There is the need to detect an overlap syndrome early. An early classification will guide the management plan of such patients. The traditional high dose steroid for the treatment of SLE and inflammatory muscle disease may be hazardous in overlap syndromes.

This study aims to determine the effect of Diversification, Intellectual Capital and Business Risk on Firm Value. This research is a causal study with a quantitative descriptive approach with the object of research on companies - companies included in LQ 45 that are on the Indonesia Stock Exchange in Jakarta. The research data is secondary data obtained from looking at the financial statements of existing companies included in LQ 45. The variables of this study consist of independent variables consisting of three variables namely Diversification, Intellectual Capital and Business Risk. And one dependent variable is Corporate Value. The results of this study indicate that Business Diversification and Risk has an effect on company value. While Intellectual Capiral has no effect.

Fresh seeds of Piper nigrum were procured from the botanical garden of Kokan Krushi Vidyapeeth, Dapoli, Ratnagiri. The ethanolic extract of the seeds was carried out by soxhlate extraction method. Sixty four (64) Sprague- Dawley rats (average weight 150 - 240 g) of either sex were used for the experiment. The ETH and PAS drugs and Piper nigrum were given to respective groups daily for 28 days. At the end of study various biochemical parameters were analyzed from serum such as of Serum Albumin, Urea, Creatinine, Total proteins and Blood Urea Nitrogen (BUN). The kidney tissues were analyzed for Histopathology. Graph Pad Prism 7 was used for statistical analysis by one way variance (ANOVA). The value p< 0.05 considered as significant. Ethanolic seed extract of Piper nigrum (Linn.) was administered independently as well as in combination with ETH and PAS drugs. It is found that the pretreated test groups with Piper nigrum ameliorated the toxic effect of the drugs. Piper nigrum (.Linn) also showed the normalization of histoarchitecture of the kidney by confirming nephroprotective activity against ETH and PAS drugs. Based on the above results it is concluded that the Piper nigrum act as nephroprotective agent and a good bio-enhancer against nephrotoxicity induced by ETH and PAS drugs in Sprague-Dawley rats.

Very little literature has been published about the morphometry of the coracoid process of the scapula. The coracoid process along with acromian process and coraco-acromian ligament stabilizes the shoulder joint and gives structural integrity for the shoulder joint. In the present study, the length, breadth, thickness and the height of the coracoid process of the scapula is measured in 50 human dry scapula bones of adult size after careful excluding of abnormal morphology and variation. The pattern of coraco-glenoid space is also studied and the percentage is calculated. The results are compared with the previous studies and the significance of the morphological values of the coracoid bone is stated as it is an gateway for laproscopic and open shoulder surgeries.

Background: Leukaemia is a complex form of blood malignancy characterized by a high mortality rate, despite significant improvement in cancer treatments. The consumption of fruits and vegetables are inversely related to the incidence and mortality of cancer, as a result of the high level of polyphenols found in some fruits that has been reported to be potentially chemotherapeutic and having a considerable effect on haematological malignancies. Objectives: To explore the effect of Imatinib, Doxorubicin, and/or polyphenols (emodin, rhein, apigenin and cis-stilbene) on the proliferation, and apoptosis of myeloid and lymphoid leukaemia cells compared to non-tumour cells. Methods: one myeloid (K562), one lymphoid (CCRF-CEM), a leukaemia cell line and one non-tumour normal cell line (CD133) were treated with Imatinib, Doxorubicin, and/or different doses of polyphenols. The activity of leukaemia cell proliferation was assessed by Cell Titer-Glo® luminescent assay; the morphological changes of apoptosis, which includes DNA fragmentation and nuclear condensation, were detected by DAPI staining. Results: Emodin, cis-stilbene, apigenin and rhein showed different levels of effect on inhibition of ATP level and inducing apoptosis in K562 myeloid cells, CCRF-CEM lymphoid cells and CD133+ normal cells when these types of polyphenols used separately and combined with Imatinib or Doxorubicin. Generally, the CCRF-CEM lymphoid leukaemia cell line was more sensitive to polyphenol treatments alone and when combined with Doxorubicin compared to the K562 myeloid leukaemia cell line and CD133+ non-tumour cells. Conclusion: These results suggest that polyphenols have different effects according to the type of cell and polyphenol. The variant effect between leukaemia cells and non-tumour cell suggests that polyphenols are a potentially therapeutic agent for leukaemia. Polyphenols can enhance the effect of chemotherapy and reduce the required dose to induce cell death in cancer cells.

Variations in the superficial veins of the face and neck are quite common and this knowledge is important in performing various head and neck surgical procedures. Aim of this study was to observe variations in the formation and termination of the superficial veins of face and neck. We studied 30 cadavers of male and female of South Indian population which were used for routine dissection for teaching medical graduates. During the study, we found an unusual termination of retromandibular vein on both sides in one cadaver and also variations in the formation and termination of anterior facial vein, lingual vein and superior thyroid vein were found in the same cadaver.

There is growing trend of psychiatric morbidity among children and adolescents all over the world. Medications are prescribed to this age group mainly depending on data obtained from adult population. Proper study to find out exact burden of the problem and the effects of these drugs to young population has not been done in our part of the world. The study was done to identify the incidence of different psychiatric problems with the most common pharmacotherapy given in children and adolescents. It is a cross sectional observational study conducted in the Psychiatry OPD of Medical College Kolkata by the department of Pharmacology from May 2014 to October 2014. After institutional ethics committee approval and consent from guardians, 86 patients of either sex were included in the study. Patient demographics (gender distribution, age of the patients, diagnosis) and drug-related information (antipsychotic drugs, route of administration) was recorded on a customized data collection sheet. Data was analysed using descriptive statistics. 61.9% in children and 67.69% in adolescent age group were boys. Mood disorder, mental retardation and epilepsy are 3 major diagnosis encountered. Average number of psychotropic drug per prescription was 1.41±0.8. 91.73% drugs were prescribed by generic name. 80.16% of the drugs supplied from hospital pharmacy. Antidepressants (29.75%) most commonly prescribed followed by Antipsychotics (26.44%). 30% patients were receiving polytherapy. We found 1-18 year age group was common in psychiatry OPD. Most common diagnosis was behavioural and neurotic disorders, while the most commonly prescribed drugs were antidepressants and antipsychotics.

Thyroid gland is a highly vascular endocrine gland consists of two lobes connected by an isthmus present in the anterior midline of the neck against vertebrae C5, C6, C7 and T1. Many study have indicated the morphometric differences of this important gland. This study puts in an effort to study the morphological and morphometric variations of thyroid gland.

89 nonvigorous neonates with meconium stained liquor were followed in the immediate neonatal period. 41 neonates received endotracheal tube (ET) suctioning at birth and 48 neonates did not receive ET suctioning at birth. Of the 41 ET neonates 16 had meconium related morbidity /mortality at NICU stay and 25 was normal. Of the 48 non ET neonates 9 had meconium related mortality /morbidity, 39 were normal. Odds ratio of mortality/ morbidity is significantly high (2.77)in ET group with narrow confidence interval (1.063,7.234),P value 0.03.Relative risk of ET group of having nonfavorable outcome is 1.7.Tracheal suctioning of meconium in nonvigorous neonates at birth did not decrease the meconium related morbidity /mortality during NICU stay.