Statement of the Problem: When confronted with non-infectious granulomatous inflammation from the oral cavity, as pathologists it is important to relay information to the clinician to ensure appropriate testing is performed to rule out various causes of OFG

Findings: Crohn disease should be considered if abnormalities in hemoglobin, serum iron, transferrin or ferritin, Vitamin B12/folate are identified. GI endoscopy to evaluate for bowel involvement may be considered. Abnormal erythrocyte sedimentation rate or C-reactive protein studies can be seen in Fig. 5 a Low power magnification of Crohn disease. There are numerous similarities to idiopathic orofacial granulomatosis including epithelial hyperplasia, stromal edema and loosely formed granulomas with mixed inflammation.

Conclusion & Significance: typical granuloma from the lip in a patient diagnosed with Crohn disease. The granuloma is composed of epithelioid histiocytes, multinucleated giant cells, plasma cells, lymphocytes, and occasionally eosinophils  Although not always present, sarcoid granulomas can have lymphocytes along the periphery and within the granuloma. Elevated angiotensin-converting enzyme can be associated with sarcoidosis. Abnormal chest X-rays may indicate sarcoidosis or tuberculosis

Most studies are limited to listing the specific diseases in the target area and very few attempts to assess the possible consequences of changing the ecosystem. Climatic change is one of the most important global environmental problems, which potentially increase the transmission and widespread of causative agents and changes in infectious disease transmission that impacts on human health. Many disease-causing organisms are strongly influenced by climate change. For this reason. The impacts of climatic changes on human health are divided into two groups: direct impacts such as heat shock and increased mortality in a population and indirect effects. The effects have been detected worldwide; the degree and types of the effect are varied, depending on the hygiene, location of the respective countries, and socio-economic conditions. Variations in the incidences of vector-borne diseases are associated with extreme weather events. It is assumed that global warming might lead to an increase in infectious disease outbreaks. So, it predicts that climatic changes that accompany global increasing the temperature will change the transmission risk of many causative agents of many infectious diseases through worldwide. Clearly, the influence of climate change on disease is a complex process. It is recommended to improve the level of education of public health and city planning to reduce the incidence of infectious diseases. Accordingly, understanding of the impacts of climate change on human health is needed with much more studies and data being asked in detail about the impacts of climate change. We hope this information stimulates further research towards this goal.

X-linked adrenoleukodystrophy (X-ALD) is a devastating genetic disease with three main phenotypes (childhood cerebral forms, adrenomyeloneuropathy(AMN) and Addison disease(AD). Tuberculosis is the commonest cause of AD in underdeveloped countries whereas autoimmune destruction accounts for 75-80% cases in developed countries. This is the first case report of X-AMN/ALD in two brothers in Bangladesh confirmed by raised very long chain fatty acid (VLCFA). Our index patient of 19 years presented with anorexia, weakness, vomiting, weight loss for three years with increased pigmentation in perioral skin, lips, tongue, mucus membrane, palmar creases, knuckles, reduced scalp hair(figure-1a-d), postural hypotension, low BMI, was found to have low basal Cortisol (9.00 am),  ACTH >1250  pg/ml (normal<46), was diagnosed with AD. After three months he developed progressive spastic paraparesis along with cognitive declination and behavioral abnormality. His only brother was normotensive, clinically asymptomatic at presentation had only increased pigmentation on tongue, palmar crease, scanty scalp hair(figure-1,2a-d) and extensor planter reflexes. He had high ACTH(>1250 pg/ml) with normal basal cortisol (9.00am). Plasma VLCFA analysis revealed significantly high C26:0 with abnormal ratio of C24:0/C22:0 and C26:0/C22:0 in both brothers, with normal level in mother(table-1). MRI (T2 & FLAIR) showed bilateral hyperintense basal ganglia in index patient(Figure2:3a-c). Electrophysiological studies of nerve (SEPs, VEPs, BAEPs, NCS, EMG) were normal in both. Both were given steroid replacement. After three years, index patient became bed bound with slurred speech, urinary urge incontinence and his asymptomatic brother developed spastic paraparesis with cognitive impairment. None had gonadal impairment. Follow up MRI revealed lesion in brainstem in both along with atrophy of thoracic segment of spinal cord in index patient(Figure2:4a-f) and cerebellum, internal capsule involvement in his brother(Figure3:5a-d). Both were of pure AMN variety but due to presence of cognitive impairment and behavioral abnormality they can be categorized as rare cerebral variety of AMN

There is no dought that veterinary dentistry has been a developing field through years specially in small animal practice , as animal grow older develop more both dental and periodontal problems either due to diet or acquired causes such as trauma leading to to some serious problems as crown fracture and even jaw fracture. In this article focusing more on crown fractures as a commonly presented problem to small animal clinics around the world easy to observe but to deal with the case properly to avoid some serious complications and to help maintaining the tooth function other than extracting the tooth, how to diagnose the case properly ,types , complications and proper treatment is the main aim of this article.

BACKGROUND: Waste management is of crucial concern for public health. Inadequate solid waste management heightens the morbidity and mortality in various ways. In many developing countries, the development of waste management has not kept up with the rapid urbanization and growing consumption and has therefore grown to a big problem. The increasing difficulty in managing wastes in Nigeria has become one of the most intractable environmental issues.

OBJECTIVE: This study seeks to evaluate the solid waste management practices among residents Buari Ishola Isibo in Ede North Local Government Area, Osun State, Nigeria.

METHODOLOGY: A descriptive cross – sectional study was used and multi-stage random sampling method was employ in selecting 60 households of Buari Ishola Isibo in Ede North Local Government Area, Osun State, Nigeria. Questionnaire was used for data collection and data was analyzed using SPSS version 21. RESULTS: The age of the respondents were between 15 – 60 years and above. 29 (48.3%) were between 31 – 60 years old, 31 (52.0%) were males, 40 (66.7%) were married, 57 (95.0%) were Islam and Yoruba. 29 (48.3%) earned 10,000 – 30,000 monthly, 23 (38.3%) had secondary school education, 39 (65.0%) were traders and 27 (45.0%) have 6 – 10 households respectively. Of the 60 respondents, 28 (46.7%) collect their refuse in an open dustbin, 35 (58.3%) empty their dustbin into river/stream, 24 (40.0%) empty their dustbin twice a week. 47 (78.3%) had no communal refuse depot in their community, 35 (58.3%) uses river/stream as their predominant community refuse depot and 44 (73.3%) make use of open dumping as their main refuse disposal methods.

CONCLUSION: Inadequate solid waste management heightens the morbidity and mortality in various ways. Right solid waste management is prerequisite to aesthetic living conditions in any environment. Maintaining effective solid waste management practices in any community will help curbing the spread of infectious diseases causing organisms, environmental hazards and improve the standard of living. Keywords: Assessment, Solid, Waste, Management, Practices

Is there a way to escape Covid-19 or illnesses of urgent pandemic and move the important things back to the centre of our lives? Is there a way to recapture the vitally crucial things in life? Checking through the scripture, God responds to Israelites’ distress by providing quail as a means of survival and healing. Research discover the unique data of healing quail eggs. With reference to quail egg and nutritional values that it contains. Tracking back historically in the scripture. Egyptians were known to quail for meat and while China researched had it that quail birds were raised as pets as singing birds that during the 11th century quails was brought from Japan to China. In addition to that research has it that one quail egg contains (9) grams antioxidants that mat help treat symptoms allergic. Main Objective for this presentation is considering the evaluation dimensions of vegetable protein sources in diet of growing and laying quails reared in a poor community in job creation and opportunity for innovation for pharmaceutical organization for commercial for wholeness consumptions. It is intended that fulllife circle stages of entrepreneurship would be taken into consideration wherever possible. However, how social entrepreneurs are making the best use of technology will be investigated and documented. Forging a new stable equilibrium that releases trapped potential; or alleviates the suffering of the targeted group and through imitation and the creation of a stable ecosystem around the equilibrium ensuring a better future of the targeted group and even the world at large.

Epilepsy the second most chronic neurological disorder after stroke affect 0.5-2% population worldwide .Antiepileptic drugs though remain the corner stone in management of epilepsy in majority of patients but still 30% of patients continue to have seizures or experience unacceptable pharmacological side effect. Electrical stimulation of vagus nerve is an effective and promising neurophysiological treatment for patients with refractory epilepsy who are either unsuitable candidates of surgery or falls in category of surgically refractory epilepsy.The VNS is indicated as an adjuvant therapy with antiepileptic drugs (AED) for patients more than 12 years of age having uncontrolled primary generalized epilepsy or partial epilepsy with or without secondary generalization. VNS produces stimulation of vagus nerve nuclei especially nucleus of solitary tract leading to wide spread activation of cortical and subcortical pathways like raphe nuclei, locus cerulus , thalami and other parts of brainstem. This action increases the seizure threshold accounting for its anti-seizure activity.Most of these acute side effects are related to initial stimulation and resolve spontaneously over a period of time without even stopping the stimulator. The optimal efficacy in regards to seizure control is generally attained in few months to 1-2 years and the positive effects improve over time unlike anti-epileptics . It accounts for more than 50% reduction in seizure frequency in one third, 30-50% reduction in another one third and the remaining show no response. The Development of VNS for the treatment of epilepsy has demonstrated well the translation of concepts gained through laboratory research in to clinical therapeutics

Background: Quality of Life (QoL) and its determinants are significant in all stages of life, including pregnancy. The physical and emotional changes during pregnancy affect the QoL of pregnant women, affecting both maternal and infant health. Hence, assessing the QoL of pregnant women is gaining interest in literature. We, therefore, aimed to describe the QoL of pregnant women during physiological pregnancy and to identify its associated predictors in women attending a public healthcare institute of Quetta city, Pakistan.

Methods: A cross-sectional study was conducted at the Obstetrics and Gynaecology Department of Sandeman Provincial Hospital Quetta city, Pakistan. The respondents were asked to answer the Urdu (lingua franca of Pakistan) version of the Quality-of-Life Questionnaire for Physiological Pregnancy. Data were coded and analysed by SPPS v 21. The Kolmogorov–Smirnov test was used to establish normality of the data and non- parametric tests were used accordingly. Quality of Life was assessed as proposed by the developers. The Chi-square test was used to identify significant associations and linear regression was used to identify the predictors of QoL. For all analyses, p < 0.05 was taken significantly.

Results: Four hundred and three pregnant women participated in the study with a response rate of 98%. The mean QoL score was 19.85 ± 4.89 indicating very good QoL in the current cohort. The Chi-Square analysis reported a significant association between age, education, occupation, income, marital status, and trimester. Education was reported as a positive predictor for QoL (p = 0.006, = 2.157). On the other hand, trimester was reported as a negative predictor of QoL (p = 0.013, = −1.123).

Conclusion: Improving the QoL among pregnant women requires better identification of their difficulties and guidance. The current study highlighted educational status and trimester as the predictors of QoL in pregnant women. Health care professionals and policymakers should consider the identified factors while designing therapeutic plans and interventions for pregnant women.

Keywords: profile, predictors, maternal Quality of Life, physiological pregnancy, cross-sectional analysis

Objectives: The definitive management of pterygium is surgery, but recurrence has remained a major challenge. This is to study the efficacy of suture-less glue-free amniotic membrane grafting in the prevention of recurrence and associated complications

Materials and methods: It was a prospective interventional noncomparative study conducted between June 2016 and February 2017. Twenty-one consecutive patients with 21 various grades and types of pterygia were studied. The patients had pterygium excision with adjunctive suture-less dehydrated glue-free amniotic membrane (Bio DO ptix amniotic extracellular matrix by Bio Diogics Cordova, Tennessee, USA) graft.

Results: There were 10 (47.2%) males and 11 (52.4%) females with a ratio of 0.9:1. The mean age was 36.3±8.74 years. The mean follow-up period was 14.6±3.09 months. Six (28.6%) of the patients had recurrent pterygia while 15 (71.4%) had primary pterygia. Three (14.3%) cases were stage 2 nasal pterygia, 14 (66.7%) were stage 3 nasal pterygia, 4 (19.0%) were stage 4 nasal pterygia. During post-operative follow up, 3 (14.3%) cases of pterygia reoccurred in three patients, two with recurrent pterygia and one had primary pterygium. There were 5 cases of pyogenic granuloma. Four of the pyogenic granulomas resolved with the of topical 0.1% Dexamethasone while one which did not resolve by the conservative management was surgically excised.

Conclusion: The prevalence of pterygium reoccurrence was 14.3%. Suture-less glue free amniotic graft appeared efficacious in the management of pterygium in this study

Keywords: Pterygium, amniotic membrane, reoccurrence

In 2014, she discover the Floral Therapy and  be graduated with International Certification in Bach Healingherbs Florals - HEALING HERBS INTERNACIONAL (England) - working for over 6 years with Bach Flower Essences systems, California, Saint Germain, Arizona Desert, Bush Australian, Minas, Mata Atlantica e Daughters of Gaia. works dowsing for organic analysis of diseases and dysfunctions. As a clinical pharmacist, she acts on the main non-prescription drugs, herbal medicines, aromatherapy and vaccines. For to 9 (nine) long years, she was a coordinator by Quality management in immunobiological processes: vaccines and tests in    Instituto Tecnológico de Imunobiológicos, Biomanguinhos - Fundação Oswaldo Cruz – Rio de Janeiro, Brazil

Responsible for the Water Monitoring Program, preparation of all procedures related to the validation and collection of water, preparation and review of flowcharts, descriptive memorials and as-built and executive plans of the Bio-Manguinhos programs, improvement of production processes based on Q8, Q9 and Q10 using the tools: risk analysis, mapping of production processes by PMBOK and BISAGE, production indicators, technical review of documentation for clinical studies and development of new products. Monitoring in international and national inspections of the main regulatory bodies