Preservation of the aesthetical aspects of the traditional buildings especially the traditional Malay house is relatively unsolved due to the limitation of the material used specifically the timber. The traditional Malay house system is basically a modular system in terms of measurement, panel dismantle-reassemble method, expandable and moveable as well. Modular system allows many advantages in construction process and final production. Some of the lists are cost-effectiveness in terms of time consuming in site, labour, product materials and many more. The quality of modular system also can be monitored wisely as it is develop in factory in mass production according to the design. This paper proposes the adaptation of modular system in modern housing that integrated with the traditional Malay house component specifically the non-structural component such as the wall system. The issues of modular using the traditional components will be analysed using observation and site visit and analysis. The system generated can be applied to the housing development in Malaysia and in the meantime preserving the aesthetic elements of the traditional Malay house. The outcome of this paper will acknowledge a concept of modular housing system adapting the traditional wall element in building environment, and appreciating the aesthetic value of the traditional Malay house as well.

Ultrasonography is a widely used imaging technique that has many clinical applications. The early staging of the metastatic carcinoma is one of these widely uses. FNA and core biopsies have exceedingly replaced the surgical biopsy. The ultrasound-guided biopsy has shown great and more accurate results for breast cancer detection more than the use of one method alone. In this study, we aimed to determine the role of ultrasound-guided biopsy in breast cancer. The procedure was performed on 32consecutive patients that were enrolled at Shaukat Khanum hospital in this Cross-sectional comparative analytical study. Ultrasound-guided core and FNA-guided biopsies were performed for all 32 patients. The accuracy of breast lumps biopsy with ultrasound guidance biopsy was more accurated as compare to non ultrasound. Out of 32 patients 1(3.1%). was diagnosedwith acute inflammation, 16(50.0%). for breast metastatic carcinoma, 2(6.3%). for chronic inflammation, 1(3.1%). for ductal epithelial carcinoma, 1(3.1%). for fibrocystic, 1(3.1%). for the fibroepithelial lesion, 1(3.1%). for lymphocytic yield, 7(21.9%). were normal results and 1(3.1%). for stromal fibrosis. In conclusion, an Ultrasound-guided biopsy is highly accurate, and more effective and feasible method than the ultrasound examination alone and excisional surgery. Recently US-guided biopsy procedure is widely used for the diagnosis of lumps in breast cancer patient.

The number of customers at Giant Citra Raya over the last five years (2011- 2015) has decreased significantly, due to many factors including poor service quality and poor customer care. Likewise Extra Giant Switching Customer behavior has Negative Net Switching, when compared to the three brands (Carrefour, Hypermart and Lotte Mart). This low customer loyalty index is due to poor service quality. The research design is explanatory, where sampling method is a non-probability sample (non-random sample). The sampling technique uses accidental sampling, in which the researcher has the freedom to choose who to meet which can be sampled according to the requirements of the existing population. The method used in this research is survey method. The average customer population is 2,070,823 / 12/30 = 5752 per day, with Slovin samples of 152 respondents. Quantitative analysis method with Analytical Path Analysis tool and SPSS tool version 2.33. Prior to the analysis conducted test of questionnaire instrument with validity test and classical assumption. After analyzed with Path Analysis continued with test of determination analysis (R Square), partial test of hypothesis (t test) and simultaneously (F test) with 5% error tolerance level. The result of this research is that Service Quality and Customer Satisfaction have a effect on Brand Image and Customer Loyalty. Brand Image and Customer Loyalty are still influenced by other variables other than Service Quality and Customer Satisfaction, therefore need to do further research.

Dentinogenesis Imperfecta is an autosomal dominant disorder of dentine affecting primary and permanent dentition. Mutation in dentin sialophospho protein on the long arm of chromosome 4 results in this defective dentin. The clinical appearance of teeth is characteristic showing an amber like translucency and severe attrition. It can also occur in association with osteogenesis Imperfecta, a genetic disorder of type 1 collagen. Here we present a case of Dentinogenesis Imperfecta associated with Type 1 Osteogenesis Imperfecta in a 14-year -old girl.

In India, Pteridophytes are particularly distributed in the Himalayan and coastal regions. The variable topography and climate conditions of India contribute to a rich diversity of its flora and Pteridophytic diversity. Kotgarh and Rampur forest division region has rich biodiversity due to the great altitudinal variations with the Pteridophytes found in shady and moist patches of the regions. 22 species of pteridophytes belonging to 10 families and 16 genera have been reported in the present study. Dryopteridaceae and Pteridaceae with 5 species, Polyodiaceae and Thelypteridaceae with 3 species and remaining Families with single species have been reported.

Toxoplasmosis has been described as the most widespread zoonotic disease of humans and other animals. Although Toxoplasma gondii infection in high school girls has been investigated in many countries, surveys have not been available in high school girls in Yemen. This study was performed to investigate the seroprevalence and risk factors associated with T. gondii infection among high school girls in Ibb city, Yemen. The study was carried out during the period February to December 2016. The sera from 220 volunteer girls were evaluated for T. gondii antibodies (IgM and IgG) using ELISA method. The seropositive rate of T. gondii was 18.2%, and 81.8% of high school girls was seronegative in anti-Toxoplasma IgG, while all cases (100%) were seronegative for IgM. Among the risk factors evaluated, only the presence of cats in home (p = 0.004) was observed as a significant risk factor associated with T. gondii infection. The results of this study may be useful for the design of optimal preventive measures against infection with T. gondii.

Liver transplant is the corner for patients with end stage liver diseases. Posttransplant patients face many challenges including poor general health, physical inactivity and emotional problem. This article reviews studies that explored the impact of physical activity on health related quality of life (HRQOL) for post liver transplant patients. To collect evidence to supporting the relationship between physical activity and HRQOL for post liver transplant patients, a search of the PubMed, CINAHL, Psych Info, EbscoHost, Medline, and ProQuest Dissertations and Theses databases was conducted using key phrases, including chronic liver disease, liver transplant, post liver transplant, liver transplant and physical activity, liver transplant and health-related quality of life. The main search parameters were studies written in English and those conducted between 2005 and 2014. The initial search resulted in 957 records. There were 246 duplicate records. These records were removed. Records were excluded if patients were pediatric, secondtime transplant recipients or receiving more than one organ transplant or if they had active infections. First records were excluded by screening the record titles; 453 records were excluded using this method. Next, records were excluded by screening the abstracts; 214 records were excluded using this method. Finally, records were excluded by screening the entire record text; an additional 37 records were excluded using this method.

The Importance of H. pylori as an etiological agent in gastroduodenal disease had suggested antibiotic treatment as a main target for the elimination of infection and to determine the prevalence of Helicobacter pylori in patients with gastro-duodenal pathologies and the susceptibility patterns of isolates Consecutive dyspeptic patients for endoscopy were recruited in the study. Gastric biopsies were collected from the patients and H. pylori isolated and identified. The present study a total six antimicrobial agents such as Ciprofloxacin, Metronidazole, Norfloxacin, Tetracyclin, Amoxycillin and Clarithromycin were used In against 100 clinical isolates Antibiotic sus-ceptibility was determined by disk diffusion and agar dilution methods against The resistance pattern, amoxicillin and metronidazole (AMRR METR) was the most common (23.7%) amongst the isolates Ninety two (83.6%) of the 110 patients (mean age 42.5 ± 15.7, range 14–70 years) were positive for H. pylori, The antibiotic susceptibility rates were 61% for tetracycline, 54.3% for clarithromycin, 16.4% for amoxicillin and 1.8% for metronidazole. Antimicrobial susceptibility results also revealed 12 antibiotypes based on resistance to the antimicrobial agents investigated.. More than 60% of the isolates exhibited multi-drug resistance to three or four antibiotics. Studies attributed the high level of resistance to the frequent use of the drugs to treat various other infections, ineffective drug control policy and the current treatment regimen in Bikaner.

Ventilator associated pneumonia is the most common nosocomial infection arising as complication at Intensive care units. It affects nearly 8-20% of the clients admitted at intensive care units and is 27% among the mechanically ventilated patients (Al Shameri). The main purpose of this study was, to assess the knowledge and practice of Ventilator associated Pneumonia prevention among nurses at PIC Hospital Lahore. A cross sectional descriptive survey was performed to assess the knowledge and practices among Nurses. A convenient sample of n=122was used to collect the data. A structured adopted questionnaire was used to collect data. The questionnaire consisted demographic variables, Knowledge of VAP and Practices of VAP among the nurses of the ICU at PIC Lahore. The data was analyzed on SPSS version 21. Overall knowledge was satisfactory where 50% of the study participants had good knowledge and gave more than 80% correct responses about different aspects of the Ventilator Associated pneumonia prevention. 30.33% were satisfactory knowledge about the VAP prevention. Overall Practice result very good practices among 83% of the participants who were practicing 20 or more items out of 24 statements. 12.33% had satisfactory practices. Overall knowledge was satisfactory and practices were good among the nurses at PIC regarding ventilator associated Pneumonia.

A series of novel semicarbazone derivatives (BS1-22) of (2E)-2-[2-(1, 3-benzoxazol-2-ylsulfanyl)-1-phenylethylidene] hydrazinecarboxamide have been prepared. The structural conformation of the newly synthesized compounds has been established by elemental analysis, spectral analysis and melting point studies. Compounds BS1, BS3, BS9, BS10, BS11, and BS21 have been subjected to anticonvulsant screening by chemo-shock models. In the series, compounds BS9, BS10, and BS11 showed most potent result while compounds BS1, BS3, and BS21 were showing moderate results than standard drug.

Surgical removal of a broken instrument tip in the mandibular posterior region can be a difficult procedure due to proximity of vital anatomical structures of the region. Moreover, accessibility in that area is another factor that adds onto the difficulty. Thus localization of that foreign object is key in its successful surgical retrieval. Here we present such a case, with its complete management and a careful technique of retrieval.

Laryngeal tuberculosis is an extra pulmonary form of tuberculosis and is found in about 2% of all tuberculosis cases. A retrospective analysis of 31 cases of laryngeal tuberculosis was done in the present study extending for 30 years in three Medical Colleges of West Bengal, India. Out of these 31 cases in the study, 20 patients were male and 11 were female with an M: F Ratio of 1.8:1. The age of the patients ranged from 31 years to 59 years. The highest incidence of 45.2% was observed in the age group of 51 to 60 years, followed by 35.5% in the age group of 41 to 50 years and 19.4% in the age group of 31 to 40 years. All the patients presented with hoarseness of voice and cough was the second common symptom. Out of the 31 patients, 9 patients complained of pain in the throat and seven of those had referred earache also. In majority of the cases, the lesions were limited to the vocal cords, arytenoids, and posterior commissure. False cord was involved in 15 cases and ulcer over the arytenoid was found in 14 cases. Patients with lesions involving only the vocal cords, presented with hoarseness of voice, whereas lesions involving the other areas of the larynx, such as arytenoid and aryepiglottic fold presented with odynophagia. Enlargement of the regional lymph nodes was observed in 5 cases out of the total 31 cases. Most of the cases were found during the first 20 years of the study whereas only 4 cases were found during the last 10 years, which could be attributed to the successful implementation of the Revised National Tuberculosis Control Programme in India. However, the emergence of multi drug resistant strain of the causative bacillus and tuberculosis-HIV co infection has complicated the scenario at present. On histopathological examination, tubercular granuloma with stromal hyperplasia, large number of phagocytes and giant cells, epitheloid cells, Langhans cells and typical necrosis with caseation were found. Confirmation of the diagnosis utilizing a proper diagnostic algorithm and treatment with specific Anti Tubercular Drugs (ATDs) are most important in the management of laryngeal tuberculosis.

Discoloration of orthodontic adhesive during the length of orthodontic treatment and after debonding of brackets poses a difficult aesthetic situation for the clinician and the patient. A detailed review of the causes of the discoloration from a clinical perspective is detailed in the article. Demineralization of enamel and penetration of resin tags, enamel cracks, surface defects are the main causes. The type of composite used, its constituents and the curing process also affects the speed and extend of the discoloration of the enamel. Steps the clinician can take reduce the amount of discoloration of enamel like use of a slow speed tungsten carbide burs are explained. Even though some discoloration of enamel is inevitable, steps can be taken to minimize the problem to a negligible proportion.

Traumatic carpo-metacarpal dislocations without associated fracture are rare lesions. Untreated, these lesions can lead to joint instability and early joint degeneration. We report 2 cases of dorsal carpo-metacarpal dislocation of the fifth metacarpal in 2 male patients. The age was 28 years and 39 years. On clinical examination both patients had edema and deformity of the dorsal surface of the right hand. The X-ray showed a dorsal carpo-metacarpal dislocation, pure, complete in both patients. The dislocation was successfully treated by closed reduction maintained with two K-wires. Immobilization of the joint was applied for 6 weeks. At 10 months' follow-up evaluation, the 2 patients showed no pain and had had regained their previous level of activity.

In this modern era, people living in scientific world. They enjoy their life through modern scientific inventions. On the other hand, we can’t ignore the dark side like everybody becomes victim of depression, in which poverty is one of the major causes of depression. Depression may lead to psychiatric disorders among people. This was an observational cross sectional study and data was collected from the rural area. Women are diagnosed with depression more frequently than men. The finding of the result revel that poverty lead to depression which affect the mental level. The government of Pakistan should be provided more and more opportunities for the job so that to bycot the poverty.