In India only few studies are focused on hematological parameters in End Stage Renal Disease (ESRD). This study was undertaken to study haematological parameters in ESRD patients undergoing regular haemodialysis and to compare haematological parameters in these patients before and after haemodialysis. Chronic Kidney Disease is a global public health problem responsible for high morbidity and mortality with greater burden of cost of care especially in developing countries like India. Adult patients with ESRD undergoing regular haemodialysis at Tertiary Care Hospital, Hemodialysis unit were included in the study, irrespective of their etiology. ESRD was diagnosed by nephrologist with creatinine clearance < 15 ml/min calculated by Cockcroft-Gault equation, biochemical and radiological investigations. With proper aseptic precautions, 5 ml venous blood collected in EDTA vacutainer just before starting haemodialysis and after completion of haemodialysis. Mean age of the patients was 41.03±12.6 years with maximum number of male patients with diabetes mellitus with hypertension being most common cause for ESRD. There was statistically significant difference in post haemodialysis value as compared with predialysis value for haemoglobin concentration, hematocrit, RBC count and platelet count. Globally, the dialysis-monitoring strategy is principally based on measurement of biochemical parameters before and after each session of dialysis. This study indicate that most haematological parameters in Hemodialysis patients are significantly altered both pre and post haemodialysis. Thus, monitoring the haematological parameters may help in deciding erythropoietin stimulating agent dose, preventing possible complications and consequently reducing the mortality/morbidity rate in ESRD patients on haemodialysis.

The Indian system of Ayurvedic medicine has described three basic physiological constituents of human body, viz., dosha, dhatu and mala. Acharya Sushruta was a great surgeon in ancient India known today as the “Father of Shalya Tantra (Surgery)” for inventing and developing surgical procedures. Acharya Sushruta has elaborately described the defining characteristic of Shalakya tantra. It comprises of the disease of shalakya tantra as narrated by king of Videha (the author of Nimi Tantra). Acharya Sushruta first ever has described the anatomy of eye in relation to their shape, size of various anatomical components. Acharya Sushruta has also described the Netra roga in a very systematic manner. In the Uttara tantram, Sushruta recites an elaborated classification of eye disease complete with signs, symptoms, prognosis and medically surgical interventions. In the foetus, the parts of eye are originated from akasha, vayu, agni, apa and prithvi mahabhuta. Acharya Sushruta has described all anatomical structures of the eye in terms of madala, patala, sandhis, peshi, marma, sira and Dristi. Susruta delineated fine anatomical divisions mandala of eye. Different Acharyas have their own view in the utpatti (origin) of Netra during garbhawastha kala. Increased demand of Ayurveda science in the present society is required to understand the depth of Ayurvedic principle in an easy mode. Hence an effort has been made to ascertain and establish the knowledge regarding anatomical structure of netra sharir.

Background & Objectives: Peritonitis due to hollow viscous perforation is one of the most common surgical emergencies attended by a surgeon on duty. Despite many advances in anti-microbial and supportive care, the mortality rate of diffuse peritonitis remains unacceptably high (10-20%). The treatment of peritonitis and the evaluation of different therapeutic approaches are hampered by lack of precise classification. A scoring system should be able to assess the need, type and quality of the care required for a particular patient. Realizing the need for a simple accurate scoring system in these conditions the present study was undertaken to evaluate the prognosis in patients with perforation peritonitis using Mannheim Peritonitis Index. Materials & Methods: Single centered, observational analytical study conducted in Jubilee Mission Medical College & Research Institute. In our study, we have included 64 patients after meeting the inclusion criteria. As per the study protocol, patient data was collected at the time of admission and intra operatively in the Surgery Department. Mannheim Peritonitis Index score was applied to assess the outcome and data analyzed. Results and Discussion: Out of 64 patients studied, statistically significant correlation was observed between incidence of mortality and the risk factors namely, age more than 50 yrs.(25.9%), presence of organ failure(36.4%), preoperative duration more than 24 hrs.(18.6%), diffuse peritonitis(18.2%) and feacal exudates (45.5%). No statistically significant correlation was observed between incidence of mortality and the risk factors namely female sex, non-colonic origin of sepsis, presence of malignancy. Conclusion: In our study population, all risk factors included in the Mannheim Peritonitis Index namely presence of organ failure; preoperative duration> 24hrs; age>50 years, generalized extension of peritonitis and type of exudate had significant association with adverse outcome while in patients with the non-colonic origin of sepsis, presence of malignancy and of the female sex there was no significant association of these risk factors with adverse outcome (mortality). The overall mortality in our study is 12.5%. Mortality in patients with MPI score < 21 was 0%, 21-29 was 4.3% and >29 was 53.84%. This reproducible scoring system allows a surgeon to determine the severity of intra-abdominal infections, to select a more aggressive management for high risk patients and to be able to inform patient's relatives with greater objectivity.

This study was carried out to evaluate the toxicity and serum lipid profile of pet- ether leave, stem bark and root extract of jatropha curcas in male albino rats. Fourty-nine (49) adult wister rats weighing between 160-240mg/kg was purchased and 14 wister rats were used for acute toxicity study while the remaining 35 rats were randomly divided into 7 groups of 5 rats each. The normal control (group 1) received normal saline, while groups 2 to 7 administered with leave, stem bark and root extracts of jatropha curcas at low dosse (200 mg/kg body weight) and high doses (400 mg/kg body weight). The extracts were administered orally for seven consecutive days, while the animals were sacrificed on the 8th day; blood samples were collected, allowed to stand for fifteen minutes and then centrifuged to obtained the serum for lipid profile analysis. This result showed that the oral administration of the leave, stem bark and root extract of Jatropha Curcas possess hypolipidemic activity and may be useful in the management of cardiovascular disease. While acute toxicity (LD50) of the Leave, Stem Bark and Root Extract of Jatropha Curcas is greater than 5000mg/kg hence its declared practically non-toxic to the experimental animals.

Mandibular reconstruction is a complex procedure and is a challenge to the surgeon. Reconstruction is required following resection of mandible due to benign or malignant pathology, osteonecrotic mandible that could not be treated conservatively. Reconstruction modalities have changed significantly over the years with the introduction of newer techniques and technologies. This article reviews and summarizes the various reconstructive modalities for mandibular defects of past years, comparatively newer reconstructive options available and the recent advances in reconstruction done by Patient-Specific Implants produced by virtual planning.

No Abstract

Background: Albumin is a family of globular proteins, the most common of which are the serum albumins. All the proteins of the albumin family are water-soluble, moderately soluble in concentrated salt solutions, and experience heat denaturation. Albumins are commonly found in blood plasma and differ from other blood proteins in that they are not glycosylated. Substances containing albumins, such as egg white, are called albuminoids. It contributes to the oncotic pressure of plasma and to maintaining the distribution of extracellular fluid between the vascular and extravascular compartments. Hypoalbuminemia is associated with poor tissue healing, decreased collagen synthesis in the surgical wounds or at anastomotic sites [1], and also plays a role in the impairment of immune responses, such as macrophage activation and granuloma formation. Although it is well established that hypoalbuminemia, as a marker of malnutrition and disease, is associated with greater risk of adverse surgical outcome, previous studies have been based on relatively small samples and selected types of operations and have failed to adequately separate the predictive ability of albumin level from other risk factors. Aim of study: To determine whether pre-operative serum albumin level can be used as an independent predictor of post-operative morbidity and mortality. Methods: This is a prospective comparison study conducted in general surgery department, Jubilee Mission Medical College. The source of the data will be all patients who undergo gastrointestinal surgery with resection and anastomosis in the Department of General Surgery, Jubilee Mission Medical College, Thrissur from December 2017 to May 2019. Patients are investigated preoperatively for liver function test, renal function test, thyroid function test and urine- protein creatinine ratio (obtained from urine microscopy) to rule out secondary causes of hypoalbuminemia and are classified into two groups:- normal albumin level and hypoalbuminemia. Patients with normal serum albumin level are compared with patients of low serum albumin for length of hospital stay, resumption of oral diet, surgical site infection and mortality. Results and Discussion: The preoperative albumin levels ranged from 2.1 to 3.4 g/dl with a mean value of 3.03 g/dl. In most other similar studies [1-4], a similar cut off normal range (3 or 3.5 g/dl) was assigned and patients were grouped into two based on this. To explore the possibility of using serum albumin as a simple and low-cost prognostic tool to predict the risk of adverse surgical outcomes, we used different statistical methods. Mann-Whitney U test has been performed to find out the significant role of albumin levels for length of hospital stay (Median 10.5 days and 8 days) and delay in resumption of diet (Median 5days and 3days) among two groups and it showed that there was statistically significant association with albumin levels between two groups in length of stay (p=0.021) if we classify the length of hospital stay as less than 10days and more than 10days. It is statistically significant in resumption of diet (p<0.001). There was a significant relationship found between the occurrence of surgical site infection and albumin levels. Where it was also found that those with low serum albumin had increased rates of complications (60%) against those with normal serum albumin levels 32.5%.15% mortality cases were reported; of which 22.5% falls in low serum albumin level group where as 7.5% in normal albumin level group. Conclusion: In view of these results, we conclude that preoperative albumin is a good prognostic indicator for predicting the outcome of surgery. It is a cheap and easily applicable test. By estimating albumin levels in surgical patients before surgery and adequately correcting lower levels where necessary, post-operative morbidity could be reduced in these patients.

Background: Fine Needle Aspiration Cytology (FNAC) is worldwide accepted, inexpensive, minimally invasive and very accurate method today especially in commonly encountered clinical problems like salivary gland lesions which range from non-neoplastic lesions like inflammation, cysts, and commonest benign tumours like pleomorphic adenoma to malignant lesions of variable malignant potential. FNAC is major diagnostic tool and is of great relevance in head and neck lesions, including major salivary glands as they are easily accessible target sites. The aim of this study was to evaluate spectrum of salivary gland lesions with their clinical presentations and to study the cytomorphological features of various salivary gland lesions, and to evaluate its sensitivity and specificity of FNAC in salivary gland lesions whenever histopathology was available. Material and Methods: A total of 150 cases of salivary gland lesions were analysed both retrospectively and prospectively from January 2010- December 2015 at Department of Pathology, of a tertiary care medical college Hospital. Cyto-histopathological correlation was interpreted wherever available. Results: In the 150 cases thus analysed, the male to female ratio was 1.14:1. Parotid gland was involved in 73.34 %, submandibular gland in 23.33 %, and other minor salivary glands in 3.33% of patients. There were 57.33 % cases of neoplastic lesions and 42.67% cases of non-neoplastic lesions. Chronic sialadenitis (22.67%) was the commonest non neoplastic lesion. Pleomorphic adenoma (40.67%) was the commonest benign neoplasm and Mucoepidermoid carcinoma (9.33%) was the commonest malignant neoplasm. The overall sensitivity, specificity and diagnostic accuracy of FNAC for salivary gland lesions were 93.48 %, 100% and 94.23 %, respectively. Conclusion: Fine-needle aspiration cytology is a very useful diagnostic tool for superficial palpable tumors of salivary glands. It has high rates of sensitivity, specificity, positive predictive value in diagnosing salivary gland lesions and hence a valuable tool in the diagnosis and management of patients.

Heterotopic pancreas is a rare condition with a probable incidence of 1 per 500 upper abdominal operations. Findings are incidental and are usually asymptomatic. Heterotopic pancreas is seen at different sites in the gastrointestinal tract. A 62 year old male presented with complaints of epigastric pain, nausea, vomiting and constipation since 3 months. The diagnosis of malignancy was based upon the findings of abdominal ultrasonography, CECTabdomen and Upper G.I. endoscopy.

Natural products, such as plants extract, either as pure compounds or as standardized extracts, provide unlimited opportunities for new drug discoveries. The research is aimed to investigate the physicochemical properties and characterization of Eucalyptus camaldulensis leaves oil. The physicochemical were evaluated using the standard procedure and the oil was fund to be light yellow color having camphor like smell. The pH of the oil at 22oC was found to be 4.62 while the % oil yield, Optical activity, Refractive index at 27°C, Specific gravity at 27°C, were found to be 49.5±1.021, +34.2°, 1.4384 and 0.812 respectively. The absolute and kinematic viscosity of the leaves oil were 102.30 and 88.20 respectively and the Total acid number (TAN) in mg KOH/g, Iodine number and saponification number were 1.67, 109 and 110.00 respectively. GC-MS revealed the presence of 16 compounds representing 86.96 % of the total oil. The major component was 1,8-cineole (49.08 %), Eucalyptol (34.42) followed by α-pinene (23.90 %), while L-pinocarveol (8.98 %) and globulol (2.71) were the least components. Also α-terpineol, myrtenol, camphene and ciscarveol were present in the oil. The result revealed that Eucalyptus camaldulensis leave oil consist mostly of oxygenated monoterpenes that could be very useful for human, animals and industries, also the oil met the FOA/WHO standard of oils. Therefore, these essential oils could be considered as promising substances for development of new drugs. Hence it potential for medicinal and pharmacological uses.

Impaction is defined by Kuftinec and Shapira as a condition with embedded teeth in socket so that its eruption is prevented and will be locked in that position by either bone or adjacent teeth. Unlike isolated impactions multiple impactions may be due to the underlying syndromes or disorders. In cases where confusion exists in differential diagnosis additional examinations might become necessary to exclude systemic and metabolic disorders.

The utility of Artificial Intelligence (AI) to design is mainly concerned with trying to make systems smarter through getting to know how to enable them to represent and control the real global understanding. It is likewise about contemplating studying how designers observe human intelligence to design, and with looking to make computer aids to design greater knowledgeable. Presently the principle topics inside the utility of Artificial Intelligence are to discover the formal illustration of the layout information, and additionally to expand strategies for reasoning with or applying this expertise. Computers have historically been capable of cope with the application of the legal guidelines of science, expressed in mathematical techniques. Artificial Intelligence (AI) mainly permits illustration of heuristic (or rule based) understanding this is less effortless or simple to explicit the use of mathematical methods. This, a part of artificial intelligence is in particular concerned with the development of such representations is called professional structures or more typically information based totally systems. This paper covers the various steps and ideas involved in adding synthetic Intelligence to the layout of mechanical structures. In this paper, a broad audit with respect to the uses of the Artificial Intelligence, in conjunction with its connection between the mechanical building for the method of mechanical imperfections identification and design layout configuration is proposed. This paper accommodates the précis or synopsis related to the precise utilizations of Artificial Intelligence in the field of mechanical Eng. Several applications, like errors identification, Analytic indicative Framework machine, mechanical shape and structure investigation, and mechanical layout plan are notably inspected. This study uncovers that the Artificial Intelligence based smart system is broadly utilized generally in the total mechanical Engineering designing area. This paper likewise presumes that the Mechanical Engineering and designing field can be effectively combined with different other Artificial Intelligence based innovation era to make it progressively successful to improve in the mechanical framework.

This paper reports the results of an investigation into the use of mobile assisted language learning for learning Arabic as a second language in the context of Saudi Arabian higher education. The purpose of this study was to explore what kinds of mobile learning devices second language Arabic learners and their teachers currently use and how they use these devices for learning the Arabic language. This mixed-methods study employed a sequential explanatory design, incorporating questionnaires and semi-structured interviews with second language students and their teachers. A total of 154 teachers and 492 students participated in the quantitative phase of the study whilst 14 teachers and 16 students took part in the qualitative phase. The results showed that smartphones the most widely used mobile device among second language Arabic learners and their teachers. Their current use of mobile devices was focused on social media apps such as YouTube and WhatsApp to support Arabic language learning.

Pre-eclampsia is one of the common complications of pregnancy and contributes significantly to high maternal and perinatal morbidity and mortality, especially in developing countries like Bangladesh. Objective: The aim of this study is to identify the risk factors and maternal and foetal outcomes of pre-eclampsia patients. Methods and Materials: This descriptive and observational study with data from the Department of Obstetrics and Gynaecology in Sir Salimullah Medical College and Mitford Hospital, Dhaka, during July 2011 to December 2011. Participants 123 pregnant women with pre-eclampsia included in the study. Main outcome measures Identify the risk factors associated with maternal & fetal complications, maternal and perinatal mortality & morbidity and incidence of pre-eclampsia. The patient with particular reference to age, parity, religion, occupation socioeconomic condition, gestational age, rapid weight gain, family history of hypertension and pre-eclampsia, obesity, new paternity, preexisting vascular disease, thrombophilias, previous history of pre-eclampsia, blurring of vision, pain in epigastrium, or pain in right upper quadrant, diabetes mellitus etc. Results: The incidence of pre-eclampsia is 4.3% and majority of the patients was found to be of 3rd decade. More than a half (51.2%) two third of the patient were primigravida. Maximum (65.9%) number was found in the gestational age group of 37 to 40 weeks. Lower abdominal pain 15.4%, Swelling of legs 15.4%, Headache 11.4%, less foetal movement 9.76% and Blurring of vision 8.13%. Mild pre-eclampsia was 44.0% and severe pre-eclampsia 56.0%. Fundal height had corresponded with 29 to 34 weeks in 42.0% patients, presentation was cephalic in 84.0%, fetal heart sounds was audible in 87.8% cases. The mean systolic and diastolic blood pressure was 164.76±9.34 mmHg and 101, 83±8.64 mmHg respectively and all patients had cephalic presentation. Fresh still birth was 3.5%, macerated still birth 1.8%, and Prematurity and IUGR were 7.0%. More than one third (36.4%) was low birth weight and male of female ratio of the babies were 1.1:1. According to APGAR score >7, were 51.5% and 81.8% during 1st and 5th minutes after birth respectively and 16.2% babies received neonatal resuscitation. Conclusion: Pre-eclampsia usually occurs in third trimester, and maternal outcome is better than fetal outcome although the maternal response to the treatment is in positive side.

Subfertility and unconstrained premature birth or unsuccessful labor is two types of conceptive disappointment. Subfertility influences about 10% to 15% of couples. Then again, the danger of fetus removal has been affirmed is about 15% to 20%. The differentiation among essential and auxiliary repetitive pregnancy loss can be made. Essential RPL is depicted as RPL without a past continuous pregnancy past 28 weeks' incubation, while auxiliary RPL is characterized as a scene of RPL after at least one past pregnancies advancing past 28 weeks' development. The main objective of this research is to find out the risk factors of recurrent pregnancy loss. The specific objectives are; to identify the origin of the pregnancy losses, to identify the probable therapeutic targets, and to provide recommendations regarding organization of care for couples faced with RPL. Total 60 samples were selected and the study duration was 3 years. After investigation, it was found that few factors, such as: age, psychological pressure, environmental and occupational exposure, chronic endometritis, smoking, genetic factors, and thrombophilia screening, uterine defects, were some of the risks of RPL. Multiple pregnancy loss can have a noteworthy mental cost for influenced couples, and numerous endeavors are being made to improve medicines and reduction the time expected to accomplish an effective pregnancy.