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 present work is dedicated to the study the effect of the applied loads on the behavior of top-set angle with double web angle bolted metal beam-to-column (TSA-DWA) connection. A numerical study of finite elements for the characterization of the nonlinear behavior of metal connections types carbon steel ASTM A36 mild steel with screw fasteners. The numerical analysis is based on a three-dimensional model with 3D solid brick element, each element consists of eight nodes using the software of finite elements ABAQUS. The model takes into account material and geometric nonlinearities (contact, plasticity, large displacements). This model has calibrated on the basis of experimental results two connections with different geometric configurations. In addition, to validate the model developed.

Type AB thymoma is a thymic epithelial neoplasm composed of component spindle cell (type A) and lymphocyte-rich (type B) component. An exceptional atypical type A thymoma variant with uncertain prognosis was added to the WHO classification of thymomas in 2015. We report a case of a 62 years old man presented with clinical myasthenia. The radiological examination revealed a well-circumscribed anterior mediastinal mass. The patient underwent complete thymectomy. Pathological and immunohistochemical analysis revealed an AB thymoma with atypical component of type A. At the first year post surgery follow-up appointment, the patient was alive with no evidence of recurrence or complication. The presence of atypical component of type A thymoma may increase the risk of progression or metastasis, so extended follow-up for patients is required

Shape and grading of aggregates can influence concrete workability. The volumes of water for well graded and poorly graded vary along with cementations materials are commonly increased to adjust. The basic purpose of this paper is to show that by properly selection of aggregates and changing mixture proportions, the proportion of cementations materials provided for workability can be minimized while achieving suitable workability and strength properties. In this research study of strength properties of high Performance concrete is achieved by using diverse characteristics of aggregate and the results obtained from laboratory testing of concrete having varying aggregate characteristics. By the purpose of this work, two types of coarse aggregates have been used. The fine aggregate is normal sand obtained from a locally available (BHOLARI /JAMSHORO AREA Latitude: 25.317. Longitude: 68.217 AND 25.416868, longitude is 68.274307. Jamshoro, Pakistan) initial laboratory investigation was conducted to obtain the suitability of using the aggregates for construction work. The various tests conducted include sieve analysis, bulk density, and specific gravity. ASTM mix design was adopted for this work and mix compositions were calculated by absolute volume method. For each and every type of coarse aggregate 25 numbers cubes (150x150x150mm) were cast to allow the compressive strength to be monitored at. 56 days. Test result reveals that concrete made from a type aggregate has higher compressive strength.

Introduction: Anaesthesia as a profession comprises of a wide range of involvement from supportive specialty to surgery to one involved in wholesome and complete care of patients, not only in operation theatres but also in intensive care units and pain clinics. The aim of this study is to assess the knowledge of our patients about anaesthesia care, so that in developing countries awareness programme can be arranged to educate the public. Material and Methods: The present cross sectional survey was conducted among 500 patients visiting department for pre anaesthesia check up. Patients were asked to answer 13 items questionnaire and answers were recorded on answer sheet by senior anaesthesiologist at the time of pre anaesthesia check up in outpatient clinic. The data was statistically analyzed using the SPSS statistical software version 16 and was expressed as number and percentage as required. Results: Among 500 patients, 251 (50.2%) participants knew anaesthesiology as a separate medical discipline, 320 (64%) thought of anaesthesiologist as a doctor. Regarding the responsibility for intensive care management of a complicated surgical patient, 16 among 500 patients considered anaesthesiologist to be responsible for that. 190 among 500 patients considered the role of anaesthesiologist in pain management and among 500 patients, 220 thought that surgeon, 18 thought that anaesthesiologist and 262 thought that nurse managed pain post-operatively. Conclusion: Patients had insufficient knowledge about role of anaesthesiologists as well as their role in improving the outcome of surgery. Henceforth, there is a need to establish closer links with the community to create awareness about the role of the anaesthesiologist

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.

Teeth are very important for the appearance of an individual. The colour of the teeth is also equally important as it as a harmony with surrounding environment such as skin, hair, eye colour. The purpose of this study was to assess the association between tooth shade and skin colour among dental college students. The present cross sectional study was carried on 140 undergraduate and post graduate Dental students. After recruiting study subjects based on study criterias, The shades of middle third of labial surface of permanent maxillary left or right central incisor were taken by using the Vita pan classic shade guide. Next, skin color/tone was matched by using the Ideal Balance Quick Stick makeup shades as a guide. Results were analyzed using chi square test and spearman’s correlation. There was a negative correlation between age and skin colour which was statistically significant (p = 0.023). Conversely, there was a positive correlation between age and tooth colour which was statistically significant (p = 0.017). There was a negative correlation between gender and skin colour (p=0.430). Similarly a negative correlation was observed between gender and tooth colour which was statistically non significant (p= 0.846). There was a negative correlation between skin colour and tooth colour which was statistically significant (p < 0.000). The results of this observational study suggest that there is a significant relationship between tooth shade and skin color. Based on the relationships skin color may be a useful guide for the selection of tooth shade.

Toothbrushing is an important tool for oral hygiene maintenance. Toothbrushes should be used judiciously else there are high chances for trauma both, to the soft tissues as well as hard tissues. This review deals with effects of improper toothbrushing on oral structures. It also provides an insight into the recommended brushing force and brushing duration for effective oral hygiene maintenance.

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.

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.

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.

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.

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.

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.

For many years medical community has attempted to standardize its approach to the assessment of patients. The vital signs are a valuable parameter with which to assess and monitor a patient's response to supportive treatment and antidote therapy. Vital signs play an important role in the practice of medical toxicology beyond evaluating and monitoring a patient's overall status as they are frequently valuable physiological clues to toxicology and disease gravity. In 1970’s two paediatric physicians Howard C Mortenson and Joseph Greensher, coined a term “Toxidromes” which is a combination word of toxic syndromes. They have quoted “Some common combination of manifestation which we have termed toxidromes can give a clue to the drug involved” in an article “The unknown Poison”. Aim: This paper aims to provide an understanding on the various vital signs and symptoms which is observed during poison treatment. Methodology: An extensive review of literature was carried out to elicit information on various vital signs and toxic syndromes. Results: The study revealed that the health care professionals on understanding various toxidromes can help them to identify the type of poison, its antidote and the can provide a better treatment. Conclusion: The healthcare professionals has to undergo training on toxidromes. Which can improve the treatment and outcome in any poisoning case