Osteoporosis has become an increasingly recognized complication among patients with chronic liver disease (CLD). The aim of the present study was to assess the prevalence and risk factors of osteoporosis in patients with CLD (primary biliary cholangitis and chronic viral hepatitis B or C patients) in comparison with a group of age- and sex-matched controls. Sixty-four patients with CLD (mean age 51.66 ± 11.54 years), 48 females and 16 males were included. Age- and sex-matched individuals from the general population served as controls. Osteoporosis was evaluated by dual energy X-ray absorptiometry (bone mineral density below -2.5 T score) at the lumbar spine (LS) and total hip (TH). Vertebral fractures were established by densitometric morphometry (vertebral fracture assessment). Bone turnover was assessed by intact parathyroid hormone, osteocalcin and C-telopeptides of type I collagen in the serum. Prevalence of osteoporosis in either the LS or the TH was 45.3%, twice as high as in the controls (19.6%) (RR 2.31, 95% CI 1.42–3.75, P\0.001). Age, menopausal status, cirrhosis and advanced histological stage are not determinant factors for developing osteoporosis in patients with CLD. However, female sex, cholestasis, lower weight and height but not body mass index seem to play predominant role. Three (5.3%) patients had dorsal and LS fractures. It was concluded that osteoporosis is effectively a complication of CLD. Cholestasis in addition to female sex and lower weight and height are risk factors of osteoporosis in CLD

The purpose of this finite element analysis (FEA) is to evaluate and compare the stress distributions at the permanent molars and restorative materials according to the material used. Materials and Methods: Three dimensional Finite Element Analysis was used to compare Stress distribution generated in Class II MOD lesion using different restorative materials. Results: Software performs a series of calculations and mathematical equations and yields the simulation result. The models was restored with three different restorative material which was subjected to a force of 600 N load. Von-Mises Stress were analyzed and compared in different materials. From the results of the study, it can be concluded that Amalgomer CR performed best followed by Zirconomer and GIC (Fuji IX). Conclusion: Restoration of Class II MOD lesions with materials of higher modulus of elasticity will enable better stress distribution.

Teeth are imperative elements in the orofacial region which are pivotal for many critical physiological functions of an individual. Loss of teeth may be inevitable due to several reasons like dental caries, periodontitis, infections, facial trauma and pathologies of the jaw. It may even result due to physiologic reasons like ageing. Inorder to restore certain key physiologic functions like mastication, phonetics, and esthetics replacement of teeth is mandatory. Many treatment options are available in the current world but implants are still considered as a first go option. Here we present a clinical report of a patient who underwent full mouth reconstruction with implant-supported fixed prostheses in partially edentulous arches.

Coeliac artery anatomy has an implication on diseases, thus a grasp of the variations in the branching pattern plays the role in the assessment of the patient. This work is undertaken to study the anatomical features of coeliac trunk like length, branching pattern and it’s anatomical variations in Rayalaseema zone of Andhra Pradesh in view of great medical and surgical importance of it. The study was conducted in the department of Anatomy of Kurnool Medical college and hospital, Kurnool, Andhra Pradesh. Of the 50 specimens, manual dissection was done in 22 dissection hall cadavers and manual dissection was done in the 28 post mortem specimens regarding the origin of the coeliac trunk and its arteries. The various patterns were normal hepatolienogastric trunk in 92%, lienogastric trunk in 2%, hepatolienomesenteric trunk in 2%, coeliaco-colic trunk in 2%. 96% of specimens had complete coeliac trunk and 4% had incomplete coeliac trunk. Tripod was seen in 38% of the specimens. The supernumery branches were observed from coeliac trunk were inferior phrenic artery in 32%, dorsal pancreatic artery in 12%, superior mesenteric artery in 2% and middle colic artery in 2%. Knowledge of such variations in branching pattern of the celiac trunk is essential for liver and pancreas transplantations, pancreaticoduodenectomy, radiological abdominal interventions, laproscopic surgeries, and in trauma of the abdomen.

Impression procedure proves to be a vital initial step in achieving an accurate, passively fitting prosthesis which is an important factor for success in implant-supported prosthesis. This case report highlights a method to modify the conventional pick up technique by splinting Impression copings with dental floss and auto polymerizing acrylic resin in order to improve the accuracy of the impression.

The posterior maxillary segment is frequently devoid of bone volume to support dental implants because of the resorption of the alveolar ridge and pneumatisation of maxillary sinus. Such cases mandate the sinus lifting techniques prior to implant placement. Two main surgical approaches available and considered predictable so far are the lateral window technique and the crestal approach. Availability of various techniques, concepts and armamentarium, made the sinus lifting procedure versatile with high success rate. This article is aimed to describe the evolution of sinus lift techniques and to review the literature related to the technique considering the outcome of existing studies. An effort has been made to bring most of the available procedures under one classification for ease of understanding of the reader.

Background: Lip prints and fingerprints are considered to be unique to each individual. The study of fingerprints and lip prints is very popular in personal identification of the deceased and in criminal investigations. Aims and objectives: The aim of the study is to find the predominant lip and fingerprint patterns in males and females in the Kadapa population and also to find any correlation between lip print and fingerprint patterns within a gender. Materials and Methods: The study sample comprised of 100 students of Govt Dental College &hospital, Kadapa, Andhra Pradesh, 50 males and 50 females aged between 18 to 30 years. pink colored lip stick was applied on the lips and the subject was asked to spread it uniformly over the lips. Lip prints were traced in the normal rest position of the lips with the help of cellophane tape. The imprint of the left thumb was taken on a white bond paper and visualized using magnifying lens. Results: This study showed that lip and finger patterns did not reveal statistically significant results within the gender. In males, branched type of lip pattern associated with whorl, loop, arch, type of finger pattern was most significant. In females, vertical lip pattern associated with loop, whorl & arch finger patterns were most significant. Conclusion: Lip print and finger print could be a significant important tool in the field of forensic odontology for personal identification. however, Further correlative studies between lip prints and fingerprints could be useful in forensic odontology for sex identification.

The principle of judges' consideration of the disputes between parties in Indonesia's legal system currently still does not reflect the values of justice. Justice for everyone is different. It is not surprising that in a judge's decision there will always be someone who declares justice; on the other hand declaring it unfair. Legal remedies are actually available to test the decision taken by a judge, whether he has applied the law and justice properly. The purpose of the study is: to analyze and find the principle of judges' consideration of the disputes of parties in the current Indonesian legal system. The research method used in this study is the constructivism paradigm, a type of normative legal research and empirical legal research. The method of sociological juridical approach. The source of research data consists of primary data sources and secondary data sources, primary and secondary data sources. Using descriptive qualitative analysis. The findings indicate that the principle of judges' consideration of the disputes of the parties in every civil decision in the court is still not based on the value of justice and balance for the parties and in fulfilling the losses is still burdensome to the losing party, there will be legal remedies.

Background: morphometric analysis of the thyroid gland alters with age, sex, race, and geographical location. The Ellipsoid method also has accuracy in evaluation of thyroid volume. Aim: to study the morphometric analysis of thyroid gland and its volume by ellipsoid method. Materials and Methods: 30 (Male-23; Female-7) cadavers with age range 55- 60 years were utilized from the Department of Anatomy, Santhiram Medical College, Nandyal to study the morphometric parameters of adult thyroid glands. The morphometric parameters like length, width, thickness and weight of the glands were measured and recorded. The volume of the thyroid gland calculated by the ellipsoid method by using morphometric parameters. The formula for evaluation of thyroid volume by ellipsoid method (π / 6 x Length x Width x Thickness) of the thyroid gland. Results: The weight of the thyroid glands was 14.02+ 0.51gms in males and 13.94+ 0.55gms in females. The average weight of the male thyroid glands was more compared to female thyroid glands in the present study. The length of the thyroid glands was 4.20+ 0.19 cm in males and 3.95+ 0.15cm in females. The width of the thyroid glands was 6.2+0.12cm in males and 6.11+ 0.14cm in females. The thickness of the thyroid glands was 1.43+ 0.07cm in males and 1.40+ 0.05cm in females. The Thyroid volume was 17.95+1.45 ml (CF: 0.479); 19.59+1.53 ml (CF: 0.524) by ellipsoid method. Male thyroid volume was more compared to the female thyroid volume in the present study. Conclusion: The ellipsoid method of evaluation of thyroid volume to be further correlated with fluid displacement method in understanding morpmetric analysis of the thyroid gland.

Desmoplastic fibroma (DF) is a rare non-metastatic yet infiltrating and destructive primary tumor of the bone. This fibrous benign lesion exhibits behavior similar to desmoid fibromatosis of soft tissues. It frequently affects young adults and long bones and is infrequently seen in the craniofacial region. Amongst jaws, mandible is most frequently involved. The present case series reports varied presentations of desmoplastic fibroma involving maxilla, a very rare location. The diverse clinical and radiographic features presented by the lesion have been elaborated along with its management.

This study was conducted to determine the effect of n-butanol root extract of Leptadenia hastata and Packed cell volume (PCV) changes in albino rats. Thirty (30) albino rats comprising of both sexes were divided into six (6) groups (A - F) with each group containing five (5) rats. Group A and B were infected with Trypanosoma brucei brucei and treated with the extract at 100mg/kg and 200mg/kg respectively. Group C was infected but untreated control, while Group D was uninfected and untreated. Group E was infected with Trypanosoma brucei brucei and treated with diminazene aceturate at 3.5mg/kg. The proximate content and phytochemical properties of the extract were determined. After inoculation blood samples were collected daily to determine the parasitaemia and PCV according to standard laboratory technique. The proximate content analysis revealed the presence of dry matter, crude fiber, crude protein, moisture and ash, while alkaloids, carbohydrates, cardiac glycosides, saponin and terpenoids were the phytochemical constituents. Infected groups showed a prepatent period of 2 days with parasitaemia value increasing significantly (P>0.05) in groups (A and B) treated with extract in respective of the dose with the PCV fairly constant. The result of this study shows that the extract has no anti-trypanosomal activity but has haematinic potential

Heavy metal contamination by chemical processing industries is detrimental to aquatic life. In this study, a factorial experimental design technique was used to optimize the chromium removal through biosorption from synthetic solution using Sapindus trifoliatus fruit powder (soapnut) as adsorbent. The process was analyzed and modeled using factorial design 24. The four process parameters considered were pH, metal concentration, soapnut concentration and soapnut particle size at two different levels of pH (4.0 and 8.0), metal concentration (100 and 500 mg/L), Soapnut concentration (5 and 10 g) and soapnut particle size (3 and 12 mm). Experiments were carried out in a bubble column system with working volume of 2L. The efficiency of chromium removal during an exposition time of 72 h was studied. The results were statistically analyzed using the Student’s t-test and analysis of variance to define the most important process variables affecting the chromium removal efficiency. It was observed that the most significant factor affecting Cr(VI) was ascribed to metal concentration.

Background: The SCR is an operational indicator for the DOTS strategy of Revised National Tuberculosis Control Programme (RNTCP) in india. The present study was undertaken to determine the relationship between sputum smear grading and smear conversion rate among the category I smear positive pulmonary tuberculosis patients undergoing DOTS. Methods: A prospective cohort study was carried out among category I pulmonary smear positive patients registered at the DOTS centres of District TB centre Karuvelipady, Government hospital Ernakulam ,Government hospital Paravur. The patients with pre-treatment sputum grading 3+ were placed in High positive cohort (HP cohort) and those with pre-treatment sputum grading as 2+,1+ and scanty were placed in Low positive cohort (LP cohort) were followed periodically at two months (end of Intensive phase ),at three months (after one month extension of Intensive phase),at two months of Continuation Phase and then at the end of the treatment to record the sputum AFB result and treatment outcome as per the RNTCP guidelines. Accordingly, a total of 397 category I patients with 213 in HP cohort and 184 LP cohort were enrolled in the study during November 2016 to January 2017. Data were analyzed using Medcalc Online calculator. Results: After two months (end of the intensive phase), SCR was 53.52% (114 of 213) among the High Positive and 69.56% (128 of 184) in the Low Positive cohort (p-0.001).After three months (one month’s extension of intensive phase),cumulative SCR was 74.17% (158 of 213) in the High positive and 84.25% (155 of 184) in the Low Positive cohort(p-0.01).Cure rate was 68.07% (145 of 213) in the High Positive and 77.71% (143 of 184) in the Low Positive cohort. Default rate was 23% (49 of 213) in the High Positive and 12.5% (23 of 184) in the Low Positive cohort. Failure rate was 3.28% (7 of 213) in the High positive and 4.89% in the Low positive Cohort (9 of 184).Twelve patients (5.63%) died in HP Cohort, nine patients in LP Cohort (p-0.23). Treatment outcome was further compared among the patients according to their sputum status achieved at two and three months of the treatment after ignoring their initial sputum status. The cure rates for the patients who converted at two months was 92.56% (224 of 242) and for those who did not convert at two months, was 55.65% (64 of 115) (p- 0.00001). Similarly, the cure rate for the patients who converted at three months was 78.04% (64 of 82) and for those who did not convert at three months was 0% (74) (p-0.00).

This study was conducted to assess the nurses‟ knowledge & practices regarding crash cart. “Emergency nurses require a strong knowledge base in every area of nursing during their practices, from pathophysiology to psychology, pharmacology, policies and procedures, and everything in between” [1]. Drug administration is a fundamental part of every day in nursing profession. No medication is completely safe and protected in this manner. Therefore, nurses need to have an intensive and broad knowledge of the medications and its method of organization in the compelling treatment of patients whose life lies in her grasp [2]. A quantitative descriptive cross-sectional study design was performed to assess the nurses‟ knowledge and practices regarding crash cart. Data was collected through simple random sampling technique. I select public health tertiary hospital to collect relevant information and data of my study from nurses working in it. There are 265 nurses in hospital I selected 160 of them by using sampling technique with 5% estimation error. The data was analyzed through SPSS 16 version. The results were shown in tables and graphs. The main results found are,(n= 94) 58.8% participant are respondent medication checked periodically and exchanged based date on expiry, and (n=66) 41.3% participant are respondent medication not checked periodically and exchanged based date expiry. In conclusion, I would say the areas of improvement entitle to the nursing staff with increased knowledge, practice and responsibility, accountability for improving management for crash cart within the public health tertiary hospital Lahore.

Background: The vermiform appendix is a wormlike diverticulum, arising from the posteromedial wall of the caecum, about 2cm from the ileocecal orifice. A cadaveric study was conducted to ascertain the average length, the most recurrent position and the location of the vermiform appendix with respect to the tenia coli. Materials and Methods: The study had a sample size of 41 cadavers gotten from the anatomical laboratory of five Universities within the south-south geopolitical zones in Nigeria. The length of the vermiform appendix was measured using a broom stick placed at its base to get the whole length of the vermiform appendix, stretched from base to its tip then measured with a digital venire calliper to deduce the length. This procedure is carried out two or more times and the average is taken. Results and Discussions: The average length of the vermiform appendix irrespective of sex was 8.7±0.89cm, while the average length for males and females were 8.80±0.9cm had 8.36±0.73cm respectively. The location of the vermiform appendix to the taeniae coli was found constant at the confluence of the three muscular bands of the taeniae coli which forms the musculature of the vermiform appendix. The most common position of the tip of the vermiform appendix was the retrocaecal position-22(53.7%), while the other positions are pelvic-11(26.8%), postileal-4(9.8%), subcaecal-3(7.3%) and preileal-1(2.4%). None was observed for the paracaecal position. Conclusion: The morphometry and the morphology of the vermiform appendix in Nigerian cadavers have been observed to follow a trend with respect to its length and position which is in tangent with most findings over the world