The city of Kupang was assigned as the dirtiest city of number one by the Ministry of Environment and Forestry in the East Nusa Tenggara Province-Indonesia in the assessment of the Adipura award in 2018. This assessment was a further impact of the cleaning management program by the Mayor of Kupang for the period of 2012 to 2017, namely Jonas Salean, because can not to finish process garbage problems in Kupang City. Therefore, a research with literature study techniques was conducted to find the concept of garbage management strategies in the city of Kupang that can be offered to Kupang City leaders for the new period of 2017 to 2022 to resolve existing garbage problems. The results of this research indicate that the concept of garbage management strategy in Kupang City can be done with the concept of zero garbage from upstream to downstream, the concept of zero garbage as extracurricular education, the concept of green community, the concept of management conventional garbage, and the economic concept of zero garbage.

This research work was carried out in 360 eyes of 180 patients
 to study the white without pressure (WWOP) lesions regarding its incidence, morphology, distribution, associated retinal and vitreous changes and its predisposition to retinal detachment in 60 patients each of emmetropes, myopes and hypermetropes. The patients were examined by indirect ophthalmoscopy and Goldman-three mirror lens. The maximum numbers of patients were in the second to fifth decade of life. Maximum number of eyes had 0-2 diopters of refractive error. The WWOP lesions were detected in 3.61% eyes. The WWOP lesions were found to be more common in the third decade of life. There was no predilection for sex in patients of WWOP. The lesions were found more frequently in myopic eyes compared to other groups. These lesions were observed between the ora serrata and equator. Isolated lesions were more common than the confluent lesions. The superotemporal quadrant of the retina was the most frequently involved. The peripheral retinal lesions capable of causing retinal detachment were seen more frequently in myopic eyes with WWOP. The vitreous changes were observed in all the eyes with WWOP irrespective of the type of refractive error. The WWOP lesion as such may not be having any potential
for causing retinal detachment, but because of the more frequent association to the predisposing peripheral retinal degenerations and retinal breaks, it has been suggested that these eyes should be examined more exhaustively and followed up more frequently to prevent the development of retinal detachment.

Background: Difference between the benign and malignant counterparts of mesenchymal tumours is significant due to the differences in the clinical outcome and the role of the surgical pathologist in making this distinction (especially in difficult cases) cannot be underestimated.2 The aim of the current study is to evaluate the histomorphological features of mesenchymal tumours of uterine corpus. Materials and methods: was undertaken in the Department of Pathology, JJM Medical College, Davangere over a period of two years from July 2010- June 2012. Results: Out of the 492 cases, majority were benign tumours accounting to 485(98.58%) cases, followed by 6(1.22%) cases of malignant tumours and one (0.20%) smooth muscle tumour of uncertain malignant potential (STUMP). Conclusion: Differentiation between the benign and malignant counterparts of mesenchymal tumours is through the use of multivariate criteria; that is, criteria that involves several microscopic features such as differentiated cell type , presence and type of tumor necrosis, the degree of cytologic atypia, the mitotic index, and the relationship to surrounding normal structures, including extrauterine sites. Morphological features supported by proper usage of IHC markers will help in arriving at the final diagnosis.

Aim: to investigate the antifungal effect of spirulina plantensis against candida albicans. Materials and methods: In the present study, we used 60 adult rats weighing between 150 and 200gm. The rats were divided into three equal groups: Group I: Animals served as controls, Group II: Animals were subjected to Candida albicans inoculation on the dorsal surface of the tongue and received systemic antibiotic treatment, Group III: Animals were subjected to Candida albicans inoculation on the dorsal surface of the tongue under systemic antibiotic treatment and then received 15 mg/kg body weight Spirulina platensis extract orally by gastric gavage daily. After 3 weeks, by cervical dislocation, animals of the three different groups were sacrificed. Tongue specimen were dissected from each rat and prepared for histological staining done with Haematoxylin & Eosin and transmission electron microscopic examination. Results: histological examination revealed atrophy of the lingual epithelium and the surface layers was infiltrated with candida yeasts in-group II while in Group III the papillae begin to regain their normal appearance with decreased infiltration of candida to the superficial layers. Ultrastucturely, showed normal appearance of different layers of the lingual epithelium in-group I. Group II: Candida albicans yeasts invaded the keratin layer. The different layers of the lingual epithelium appeared with severely widened intercellular spaces and destructed desmosomal junctions. Group III: keratin layer appeared with disappearance of candida spherical plastopores. The different layers of the lingual epithelium showed less widened intercellular spaces and less destructed desmosomal junctions. Conclusion: Spirulina plantensis can be useful against candida albicans instead of the traditional antifungal drug.

Aim: Current study aimed to study the coeliac trunk and its branches in 50 specimens, presence of supernumery branches from coeliac trunk and its branches, and presence of any aberrant vessels. Method: The study was carried out in 50 human cadaveric specimens. Of the 50 specimens, 22 were done in the dissection hall cadavers, 28 were collected from the post mortem. The arteries supplying the liver, stomach, pancreas and the spleen were dissected. Results: The mean length of the splenic artery was 9.11 cm (ranged from 8 cm to 13.5 cm). Its tortousity index was from 1.02 to 1.29. Suprapancreatic course in 76%, retropancreatic course in 20% and intrapancreatic course in 4% were noted. Apart from the usual branches, the superior polar (30%), inferior polar (36%) and both polar arteries (8%) were found. 18% of specimens had dorsal pancreatic artery, 28% had posterior gastric artery and 12% had gastrosplenic artery. Regarding the Left gastric artery, it took origin from the coeliac trunk in 96%, from the aorta in 2% and from the splenic artery in 2% of the specimens. Conclusion: The knowledge of the branching pattern, variations in the origin and the presence of supernumery branches and aberrant arteries which had been enumerated in this study will be helpful to the surgeons and the radiologists.

Aim: The present research study aims to study the effectiveness of WhatsApp as a teaching learning tool in biochemistry for I MBBS students. Objectives: To enhance the ability of students to apply their knowledge of biochemistry to clinical case scenarios using WhatsApp as a medium of instruction and to evaluate the effectiveness of WhatsApp as a medium of teaching complementary to traditional teaching. Materials and Methods: Institutional ethics committee approval was obtained. I MBBS students were enrolled after obtaining their informed consent. WhatsApp group was formed involving the students and faculty of the department of biochemistry. Study period: 3 months (April – June 2018). Sample size: 131 I MBBS students. Topics that were earlier taught by didactic lectures were chosen and clinical scenario based discussion on those topics were initiated in the WhatsApp group thus created. Pre-test and post-test questionnaires were given before and after the WhatsApp based discussion and student feedback about the WhatsApp based teaching method was also obtained. Results: The pre-test and post-test scores were compared using paired t test and it was observed that the performance of students improved significantly after the WhatsApp sessions. An analysis of feedback from students has revealed that 78% of students felt that the WhatsApp sessions helped them to logically analyse the information taught and another 71% felt that it helped them apply their knowledge of biochemistry to clinical case scenarios. The students perceived the WhatsApp based teaching method to be effective, as evident from their feedback. Conclusion: It is evident from the study that the WhatsApp based case discussion has proved to be an effective supplement to conventional mode of teaching, though it cannot totally replace the conventional method. Therefore, it can be concluded that the social media has the potential to revolutionize medical education in the future

Introduction: Lesions of the head and neck region are routinely encountered by clinicians, in patients across all age groups with diagnosis ranging from reactive hyperplasia of lymph nodes to malignancies. FNAC of head and neck is a well accepted technique with high specificity. Aims & Objective: To evaluate the role of FNAC in palpable head and neck lesions and also to study their distribution. To assess the prevalence of different types of palpable head and neck swellings. Materials & Methods: This study is conducted over a period of 5years (2013-2017) retrospectively. Palpable head and neck lesions in all individuals irrespective of age and sex was considered and cases with scanty material was excluded from the study. Results: A total of 2598 cases were studied. There were 1649 females (63.5%) and 949 males (36.5%). In the present study age ranged from 1 year to 88 year. Common age group involved was 30 -39years (513 cases) accounting for 19.8% followed by 501 cases in age group of 40-49 years accounting for 19.2%. Most common site was thyroid (979 cases) constituting 37.7% followed by lymph node (960 cases) constituting 36.9%. Among the thyroid lesions predominant lesions were benign accounting for 25 % (245 cases) [TBSRTC system]. Conclusion: Present study confirmed that FNAC is an excellent first line investigative method, for diagnosis of palpable head and neck swellings.

First thing which strikes in the mind after coming across with post traumatic necrosis of maxilla that is it possible? Looking back into literature we found only handful of incidences with traumatic maxillary necrosis. Osteonecrosis of the mandible and the maxilla is known; however, aseptic necrosis of the maxilla after traumatic fracture is hardly reported. Management of these cases can be quite cumbersome and require utmost care. We present a peculiar case report of post traumatic necrosis of maxilla and partial maxillectomy. This case aims to help clinicians realize the need to closely follow up and treat such patients with trauma as it can lead to osteonecrosis of the bone and cause difficulty in daily activities.

Retinal nerve fiber layer thickness is affected in several ocular and systemic conditions, most commonly glaucoma and diabetes mellitus. The present cross sectional study was conducted to compare the retinal nerve fiber layer thickness in patients of primary open angle glaucoma and patients of type 2 diabetes mellitus. A total of 120 consecutive eyes of 60 patients were assigned to 2 groups of 30 patients each of primary open angle glaucoma and type 2 diabetes mellitus. Retinal nerve fiber layer thickness was measured with spectral-domain optical coherence tomography. Readings from all the areas of retina (superior nasal, inferior nasal, inferior temporal, superior temporal, nasal upper, nasal lower, temporal lower, temporal upper) were measured in both eyes. Retina nerve fiber layer thickness was negatively correlated with the duration of glaucoma, duration of diabetes and HBA1c levels. Hence, care should be taken in interpreting optical coherence tomography readings in patients of primary open angle glaucoma and diabetes mellitus. Such patients should not be over treated. The changes in retinal nerve fiber layer thickness can be used to monitor the progression or regression of diseases affecting nerve fiber layer and efficacy of treatment modalities in individual cases.

Rehabilitation of post-surgical defects maxillofacial region requires a multidisciplinary approach. Maxillofacial prosthodontist plays an eminent role in restoring the normal health and function of the patient. This review highlights the role they plan in diagnosing, treatment planning along with conventional and advanced prosthetic management of such acquired defects.

Retinal nerve fiber layer thickness is affected in several ocular and systemic conditions, most commonly glaucoma and diabetic retinopathy. The present cross sectional study was conducted to compare the retinal nerve fiber layer thickness in patients of primary open angle glaucoma and patients of primary angle glaucoma suffering from type 2 diabetes mellitus. A total of 120 consecutive eyes of 60 patients were assigned to 2 groups of 30 patients each of primary open angle glaucoma and patients of primary open angle glaucoma having type 2 diabetes mellitus. Retinal nerve fiber layer thickness was measured with spectral-domain optical coherence tomography. Readings from all the areas of retina (superior nasal, inferior nasal, inferior temporal, superior temporal, nasal upper, nasal lower, temporal lower, temporal upper) were measured in both eyes. The presence of type 2 diabetes mellitus in patients of primary open angle glaucoma significantly affected the thickness of retinal nerve fiber layer specially in superonasal and inferotemporal quadrants as compared to patients of primary open angle glaucoma. Retinal nerve fiber layer thickness is negatively correlated with the duration of glaucoma, duration of diabetes and HBA1c levels. Hence, care should be taken in interpreting optical coherence tomography readings in patients of primary open angle glaucoma having diabetes mellitus, and such patients should not be over treated. The changes in retinal nerve fiber layer thickness can be used to monitor the progression or regression of diseases affecting nerve fiber layer and efficacy of treatment modalities in individual cases.

Reconstruction of defects of the oral cavity can be challenging. The armamentarium of the reconstructive surgeon includes local and regional flaps as well as free tissue transfer. The anatomy, location, and size of the defect guide the surgeon in treatment planning to determine the type of flap best suited for a specific reconstruction. Despite the enhanced techniques of repair of cleft palate, fistula occurrence is still a possibility either due to an inaccuracy in the surgical technique or due to the meagre tissue quality of the patient. Though usually the fistula closure is established by use of local flaps but at times the site and the size of the fistula make use of local flaps for its repair a remote possibility. Tongue flap can be the most versatile flap because of its central position in the floor of mouth good vascularity makes it a choice of flap for closure of anterior palatal fistulae than any other tissues. We are presenting a case report regarding closure of anterior palatal fistula with dorsal tongue flap.

Perfusion index is a non-invasive method to assess the peripheral perfusion at a specific monitoring site measured by masimo pulse oximeter using signal extraction technology. Perfusion Index is an important measure to diagnose peripheral perfusion noninvasively. Present study is planned to find out the cut-off value of perfusion index for preterm neonates. 633 preterm neonates of 28-36 wks were followed simultaneously for perfusion index and capillary refill time. Capillary refill time more than 3 is a sign of poor peripheral circulation. Using the statistics of diagnostic tests, the perfusion index cut-off for sick preterm is 1.3sec by plotting in receiver operator characteristics curve. Capillary refill time more than 3 is taken as gold standard. The sensitivity of perfusion index is 88%. Perfusion index is a very important non-invasive measure to diagnose sick preterm.

This study aims to determine and analyze partially and simultaneously the influence of service quality, image institution, and price toward student satisfaction of LP3I Jakarta Polytechnic. The type of research is quantitative approach, with data processing done using SPSS version 24. The object of this research student, with samples 132 students from levels I, II, and III. The analytical method used in this study is to use multiple linear regression analysis. The results showed that service quality, institutional image and price simultaneously and partially and simultaneously have positive and significant influence toward student satisfaction

Objective: To study the clinic bacteriological profile and outcome of Empyema Thoracis in children between 1 month to 12 years of age admitted at Calcutta National Medical College and Hospital (CNMCH), Kolkata. Methods: Study subjects were enrolled from children admitted at Paediatrics Department of CNMCH, Kolkata with fever, cough, respiratory distress and diagnosed as Empyema Thoracis by basic investigations like Chest X Ray (CXR), Pleural fluid analysis,Ultrasonography of Chest (USG chest), blood culture and sensitivity. Result: Rapid diagnosis by basic investigations and early initiation of IV antibiotics with intercostal chest tube drainage was an effective method of therapy. The common organisms isolated were Staphylococcus aureus and Streptococcus pneumoniae. Only 4% cases of the sample size required surgical intervention. Malnutrition was an important co morbid condition. Conclusion: IV antibiotics and intercostal chest tube drainage is an effective means of therapy of Empyema Thoracis in children at resource poor settings.