Frequency of Distribution and Relationship of Nail Changes and Oral Mucosal Involvement in Classical Lichen Planus (LP)

Introduction: LP is an itchy dermatosis. It is of different types with classical LP being a common type. It most commonly affects the skin of the limbs, however, it can affect the mucous membranes, genitals and nails as well. Materials and Methods: 100 patients of classical LP presenting in Dermatology OPD of Benazir Bhutto Hospital were enrolled to assess the involvement of nails and oral mucosa in the disease. Statistical Analysis was done using SPSS version 23. Results: Out of 100 patients, 70% were free from any oral mucosal or nail involvement, whereas, 7% had both oral mucosal as well as nail involvement with classical LP. 18% had oral mucosa affected but nails spared and only 5% had nails affected without oral mucous membrane involvement with the diseases. 25% had oral mucosal involvement with reticular pattern being most common type and 12% showed nail changes with longitudinal ridging being the most common. Fisher’s exact test computed a two tailed p value of 0.0093 showing a significant association of nail changes in classical LP with oral mucosal involvement. Conclusion: Classical LP is an itchy condition which most commonly affects the skin, mucous membranes and nails. However, if oral mucous membranes are involved, the risk of having nails affected by the disease is quite significant. The distribution frequency of nail and oral mucosal changes as well as their predominant subtypes associated with classical LP in South Asians is comparable with rest of the world & other types of L

In-vitro comparison of micro-leakage between nanocomposite and microhybrid composite In class v cavities treated with The self-etch technique

Abstract BACKGROUND: When a light cure composite resin is used to restore a class V lesion, certain stresses are generated at the tooth-restoration interface. If these stresses exceed the bond strength of the restorative material, microscopic gaps are formed which eventually cause micro-leakage at the tooth-restoration interface. The objective of the present study was to compare the micro-leakage values at the tooth-restoration interface using dye penetration method between a Nano filled and a Micro hybrid light cured composite resin in class V cavities using the self-etch technique. METHODS: Sixty class V cavities were made coronal to the cemento-enamel junction in the extracted premolars. These were then randomly divided into two study groups. Group A: Self-etch; filled with P-60 (microhybrid) n=30. Group B: Self-etch; filled with Z-350 (nano-filled) n=30. Specimens were subjected to thermo-cycling at 5-55 °C±2 °C with a 30 seconds dwell time. After which they were stained with 2% methylene blue. Later, sectioned bucco-lingually and examined using a stereo microscope (magnification X4) at the occlusal, axial and gingival surfaces. Micro-leakage around the toothrestoration interface was assessed by using the degree of dye penetration in millimetres. RESULTS: There was 100% micro leakage seen at both the occlusal and gingival surfaces when using the P-60 composite. With the Z-350 composite 84% occlusal and 88% of the gingival surfaces exhibited microleakage.. CONCLUSIONS: With respect to micro-leakage in class V cavities, Z-350 was found to be a superior restorative material compared to P-60 on the occlusal surface. Overall, there is no statistically significant difference in the micro-leakage exhibited by the two restorative materials in class V preparations subjected to self-etch protoco

A HUMAN RESOURCE PERSPECTIVE ON POLICIES TO SUPPORT CORPORATE SOCIAL RESPONSIBILITY

Within the last decade, the phenomenon of Corporate Social Responsibility (CSR) has gained significance in the corporate world from a marketing context, yet very little empirical work exists to highlight its importance from a human resource context. CSR is often embedded in the sustainability agenda of the organization, in which different factors impact the CSR based human resource (HR) policies of an organization. The data were collected through interviews. In this interview, Telenor’s mission and policies for employees, society, environment and customers were analyzed. Three themes emerged in the interview that affected the CSR based HR policies: management style, economic impact of CSR on the organization and the overall CSR strategic approach of the firm. The paper concludes that CSR is strongly emphasized in Telenor Pakistan’s approach and reflected in its codes of conduct, policies as well as management style

Do I Talk Too Much in Class? A Quantitative Analysis of ESL Classroom Interaction

Teacher-learner interaction in the classroom is dictated by how well the teacher manages classroom talk-time which has a direct influence on learner achievement in an ESL Classroom. Teachers often perceive that they allocate enough time for student talk time; however, the past literature suggests that teacher talk-time takes around 70-75% of overall time in the class. The purpose of this study is to analyze the TTT (Teacher Talk-Time) in the context of ESL classroom in Pakistan. Convenience based sampling was used to assess the Teacher Talk-Time through observational method. Findings of 12 sessions (30-hours) showed that average Teacher Talk-Time was 65% of the total classroom time. The study highlights that ESL teachers need to improve the Learner Talk-Time (LTT) as the analysis showed that on average each student only gets 22 seconds of talk-time in an ESL class. A blended learning model can help ESL teachers to eliminate some of the talk-time and engage learners with meaningful activities that encourage classroom interaction in the target language

Comparison of Topical Silymarin with Hydroquinone in the Treatment of Melasma

Objective: To compare the efficacy and safety of topical silymarin 0.7% with topical hydroquinone 4% in the treatment of melasma. Place and Duration: This Randomized Controlled Trial was conducted at dermatology OPD of Akbar Niazi Teaching Hospital, Bara Kahu, Islamabad, in a period of one year from April 2020 to April 2021. Patients and Methods: Female patients having melasma were included in the study. The severity of melasma was assessed using MASI score. Group A was treated with silymarin 0.7% cream and group B was treated with topical hydroquinone 4% cream. Treatment was given for 3 months and was followed up for the next 3 months to observe relapse. Clinical efficacy was assessed in terms of percent reduction in MASI score from baseline. Results: The mean age in group A (Silymarin 0.7%)  was 35.13 ± 3.87 and in group B (Hydroquinone 4%)  was 34.16 ± 3.90. Epidermal type of melasma was most common (76.8% vs 62.5%) in both groups. There was no significant (p-value < 0.05) difference between both groups after one and two months treatment but mean MASI score of Hydroquinone 4% group (10.59 ± 5.74) become significantly (p-value < 0.05) less than Silymarin 0.7% group (8.20 ± 4.41) after 3 months. Similar (p-value > 0.05) therapeutic response was observed after one and two months treatment but it become significantly better in Hydroquinone 4% group after three months treatment. Significantly, (P-value < 0.05) higher adverse effects were detected in patients treated with hydroquinone. There was no difference (P-value > 0.05) in recurrence rate and patients satisfaction between both groups. Conclusion: topical silymarin has equal efficacy for the treatment of melasma with comparatively very less adverse effects as compared to hydroquinone

Early Antibiotic Exposure Is Not Detrimental to Therapeutic Effect from Immunotherapy in Hepatocellular Carcinoma

BACKGROUND AND RATIONALE: Immune checkpoint inhibitor (ICI) therapy is an expanding therapeutic option for hepatocellular carcinoma (HCC). Antibiotics (ATB) taken prior to or early during ICI therapy can impact immunotherapy efficacy across indications; however, the effect of ATB is undefined in HCC. METHODS: In a large international cohort of 450 ICI recipients from Europe, North America, and Asia, we categorized patients according to timing of ATB focusing on exposure within −30 to +30 days from ICI (early immunotherapy period [EIOP]). EIOP was evaluated in association with overall survival (OS), progression-free survival (PFS), and best radiologic response using RECIST 1.1 criteria. RESULTS: Our study comprised mostly cirrhotic (329, 73.3%) males (355, 79.1%) with a Child-Turcotte Pugh class of A (332, 73.9%), receiving ICI after 1 therapy line (251, 55.9%) for HCC of Barcelona clinic liver cancer stage C (325, 72.4%). EIOP (n = 170, 37.9%) was independent of baseline clinicopathologic features of HCC and correlated with longer PFS (6.1 vs. 3.7 months, log-rank p = 0.0135). EIOP+ patients had similar OS, overall response, and disease control rates (DCRs) compared to EIOP. The effect of EIOP persisted in landmark time analyses and in multivariable models, confirming the independent predictive role of EIOP in influencing PFS following adjustment for covariates reflective of tumor burden, liver function, and ICI regimen administered. In patients receiving programmed cell death-1 receptor/ligand inhibitors monotherapy, EIOP was also associated with higher DCRs (61.4% vs. 50.9%, p = 0.0494). CONCLUSIONS: Unlike other oncological indications, ATB in the 30 days before or after ICI initiation is associated with improved benefit from immunotherapy, independent of disease and treatment-related features. Evaluation of the immune microbiologic determinants of response to ICI in HCC warrants further investigation

The impact of social and family role stress on the achievement motivation of Indian teachers

For many students and teachers achievement motivation has become not just an essential part of vocational life but also infringing even on the quality of social, family and work life. Achievement motivation has been studied as one of the most positive aspect of students’ life while, occupational or role stress has been linked with individuals’ social, family and organizational sector. This study examines the impact of social and family stress on the achievement motivation of school and college teachers in Aligarh, India. Statistical analyses of questionnaire returns of 200 teachers reveal that the impact of social and family role stress was not significant on the achievement motivation of the subjects. This insignificant relationship may be attributed to the fact that Indian school as well as college teachers keep their social and family stress separate from their achievement motivation. This separation was made possible because the teachers were academically and professionally successful and this enabled them to distinguish between their personal and professional domains of life and not allowing any undue interference of outside events or happenings

Playful minds and playful designs: a childs perspective

Bibliography: p. 92-95Some pages are in colour.Includes an oversized page