In a cabinet form of Government relationship between Ministers and Civil Servants plays an important role for functioning of a successful government because the ministers are members of Parliament and direct elected by the people from their respective constituencies, so they always claim their supermacy. In the other hand Civil Servants are selected on the countrywide merit for a certain age on permanentbasis so they never forget their merits and permanent cadre. Therefore a major difficulty the adjustment of relations between the two are prevailed from the very beginning in India. In fact the relations between the ministers and civil servants are very delicate. But, unfortunately in India traditions have so far been developed to put them on a satisfactory and enduring basis. All the facts have discussed ahead in this context.
Gingival recession is multifactorial, including periodontal disease, faulty tooth brushing, iatrogenic factors like orthodontic movement, poor restorations and anatomical factors such as tooth malposition and frenum pull. Various techniques have been proposed for successful coverage of exposed root. In recent literature combination of EMD with a CAF has been investigated for recession coverage. This case report evaluates the usefulness of CAF + EMD as a root coverage procedure in Miller’s Class I or II gingival recession and showed successful root coverage at 6 months.
The Conventional Orthognathic Approach (COA) for correction of skeletal malocclusion in adult patients consist of a variable length of pre-surgical orthodontic preparation accomplishing a majority of orthodontic tooth movements to reveal the true skeletal discrepancy and obtain a precise and stable occlusion post-surgically. This is followed by orthognathic surgery. Minor tooth movements like settling of occlusion are carried out during post-surgical orthodontics. This lead to development of a new approach for ortho-surgical correction; Surgery First Orthognathic Approach popularly known as SFOA in which aesthetics is restored first (by immediate surgery and eliminating the phase of pre-surgical orthodontics) followed by occlusal corrections by routine orthodontic treatment utilising Regional Acceleratory Phenomenon (RAP). This review paper highlights various aspects of SFOA to augment our existing understanding in this aspect of ortho-surgical correction.
Supraglottitis secondary to Haemophilus influenzae serotype f infection: Case report and review of literature
Introduction: Haemophilus influenzae is an important human pathogen capable of causing serious invasive disease. The H. influenzae serotype b (Hib) conjugate vaccine successfully reduced the incidence of invasive Hib disease globally, revealing the significance of other H. influenzae serotypes. The emergence of H. influenzae type f (Hif) invasive disease has been reported worldwide. Case report: We identified a case of supraglottitis secondary to Hif in a 57-year-old female from northwestern Ontario without significant predisposing conditions. We describe the clinical presentation, disease progression, and outcome. The case is discussed in the context of current epidemiology of invasive Hif disease. Conclusion: This report emphasizes the severity of Hif invasive disease and the need for continued surveillance at the international level. We call for the development of health promotion strategies and the consideration of a vaccine against this organism.
Warthin-like variant of papillary thyroid carcinoma (WLV-PTC) is a recently described rare variant of papillary thyroid carcinoma with favorable prognosis. We present a rare case of WLV-PTC in a 29-year-old female patient with graves’ disease along with emphasis on the difficulty of positive diagnosis both clinically and histologically since the association of thyroid nodules with Graves’ disease is not common and this variant of thyroid cancer is frequently misdiagnosed with other subtypes.
Metastasis to the breast from extramammary carcinoma are uncommon. A 63-year-old male presented with abdominal pain resistant to treatment. On clinical examination, the abdomen was soft, depressible but sensitive in the left upper quadrant. Palpation of the right breast revealed a subcutaneous mobile nodule, mobile, measuring 1.5 cm long axis. A whole-body CT was requested and showed a metastatic pancreatic. Mammogram and breast ultrasound showed a relatively well limited nodule of the right breast measuring 22 mm. The patient underwent a breast lumpectomy Final haematoxylin and eosin (HE) and immunochemistry staining of the tumour and immunochemistry confirmed the diagnosis of a metastasis to the breast from pancreatic adenocarcinoma. The patient died within 2 months of initial diagnosis.
We present a patient diagnosed with intrahepatic cholestasis of pregnancy at 30 weeks 6 days of gestation. She presented with complaint of pruritus associated with hepatic cytolysis and elevated transaminases revealed by laboratory tests. The emphasis must be laid on importance of early diagnosis of intrahepatic cholestasis of pregnancy to improve the fetal prognosis and to eliminate other severe conditions associated with hepatic cytoloysis syndrome and pruritus.
The knowledge about the formation and relation of the portal vein is important for surgeons. The variation in the level of formation and the pattern of formation of portal vein is a cause of concern during surgical procedures. An abnormal formation of portal vein that was encountered during routine dissection is reported. The portal vein was formed by the union of splenic vein, superior mesenteric vein and inferior mesenteric veins. Identification of these variations is useful in managing traumatic rupture of the mesentery.
Bronchial Artery Embolization for Life-Threatening Massive Hemoptysis in a young female patient: A case report
Introduction: Massive hemoptysis is a potentially life-threatening respiratory emergency mandating immediate management. It is defined as expectoration of 300 to 600 mL of blood in a period of 24 hours. The most common etiologies include bronchiectasis, cystic fibrosis, neoplasm, sarcoidosis, tuberculosis, and other infections. While only five percent of hemoptysis is massive, some studies report a mortality rate of up to 80 percent in this subgroup, mainly due to asphyxiation. One of the novel ways to manage the later condition is transarterial embolization of the bronchial artery, which is minimally invasive, well tolerated relatively safe procedure. Here we present a case presents with massive hemoptysis due to iatrogenic arteriovenous fistula happened as a complication of previous right middle lobectomy treated successfully by coils. Case presentation: A 25-year-old female patient, a known case of right middle lobectomy 3 years ago due to lobar bronchiectasis presented complaining of less than one day of dyspnea and hemoptysis which was moderate in amount of fresh red blood, there was no fever, cough, recent history of upper respiratory tract infection, chest pain, symptoms of deep vein thrombosis, or anticoagulant use. On examination, the patient was generally ill, conscious, oriented, with average body built, without pallor, not in respiratory distress. She was vitally stable as the blood pressure was 100/65 mmHg, the pulse was 90 beats per minute, respiratory rate was 21 per minute, and temperature was 38.2 C.. Chest examination revealed decreased breath sounds on the right lung, no added sounds and otherwise it was normal. The cardiovascular system examination, neurological examination, abdominal examination, lower limbs examination was normal. Complete blood count was done, and it revealed: hemoglobin level of 14.6 mg/dl, platelet 186.000 per microliter and white blood cells count of 4100 per microliter. Coagulation studies were slightly abnormal as the PT was 15…
The numerous hydroxyl groups available in cyclodextrins are active sites that can form different types of linkages. They can be crosslinked to form linear or branched networks. Moreover, they can form inclusion complexes with polymers and different substrates, modifying their physicochemical properties. This review shows the different applications using polymers, drugs or any other guest with cyclodextrins, either by forming inclusion complexes, ternary complexes, and networks. A comprehensive literature survey was made collect the rightful utilization of cyclodextrins as complexing agents and permeation enhancers. Various techniques have been investigated to explain the methods for preparation of inclusion complexes. In the present review, an attempt was made to discuss various complexation techniques and tried to briefly highlight the potential applications, technical and economical limitations associated with these approaches.