The Role of School Administrators in Supporting Differentiation in Business English Classrooms in India

This study aimed to examine the policies, programs, and resources provided by higher education administrators in India to support differentiation in business English classrooms. The study also evaluated the impact of administrators' support on differentiation, explored strategies and best practices for supporting differentiation, and assessed the challenges faced by administrators. The results showed that higher education administrators in India have implemented various policies and programs to support differentiation in business English classrooms, including the use of technology and digital tools, innovative practices, and online courses. However, the study also revealed that there is still a gap in terms of supporting classroom management, considering learner preferences, and promoting variety in classrooms to break monotony. To overcome these challenges, higher education administrators were recommended to prioritize collaboration with teachers, provide professional development opportunities, and allocate sufficient resources for differentiation in business English classrooms

Role of staging laparoscopy in upstaging CT findings and influencing treatment decisions in gastric cancers

Background: It is estimated that 990000 new gastric cancer (GC) cases occur in the world annually. The aim of this study was to examine the accuracy of laparoscopy in staging patients with gastric cancer in comparison with preoperative computed tomography (CT) examination and to determine the influence of staging laparoscopy on treatment decisions in gastric cancers.Methods: This was a prospective study conducted in a tertiary care hospital between August 2014 and February 2016. Thirty patients out of a series of 60 patients with gastric adenocarcinoma underwent a preoperative staging CT followed by a staging laparoscopy. The strengths of the agreement between the CT stage, the laparoscopic stage, and the final histopathological stage were determined by the weighted Kappa statistic (Kw). The number of patients with treatment decision-changes was counted.Results: The strengths of agreement between the CT stage and the final histopathological stage were Kw- 0.314 (95% confidence interval [CI]; 0.03-0.66; P≥0.0001) for T stage and 0.00 (95% CI; 0.0-0.00) for M stage, compared with 0.668 (95% CI; 0.39-0.98; P≥0.0001) and 1.00 (95% CI; 1.0-1.0; P≥0.0001) for the laparoscopic T and M stages, respectively. Unsuspected metastases that were not detected by CT, were found in 12 patients at laparoscopy, all of whom had T3 or T4 locally advanced tumors evident on CT.Conclusions: Preoperative laparoscopic staging of gastric cancer is indicated for potential surgical candidates with locally advanced disease in the absence of metastases on CT and influences treatment decision making apart from preventing unnecessary laparotomies

Removable Partial Denture: A “Stopgap” arrangement or a “Stepping stone” for complete dentures?

This review is aimed to discuss the pros and cons of early and uneventful extraction routinely carried out in the dental clinics. Abrupt extractions are damaging physiologically as well as psychologically. Transition is the need of the day and should be stressed. A smooth uneventful transition from natural teeth to artificial ones is the key in a successful patient - dentist relation and a successful treatment

Functional outcomes following various reconstructive methods following various forms of maxillectomies- a tertiary centre experience

Background: The maxilla is the pivotal structure of the midface, separating the oral, antral, and orbital cavities, and providing support to the globes, lower eyelids, cheeks, lips, and nose. In addition, the maxilla play a critical role in speech, swallowing, and mastication. To evaluate the functional outcomes following various reconstructive methods following various forms of maxillectomiesMethods: Retrospective analysis of medical records of patients who underwent various forms of maxillectomies from January 2011 to December 2013. Postmaxillectomy defects were managed by either prosthesis or local flaps.Results: Forty patients had various forms of maxillectomies. Fifteen patients had Browns class 1 maxilectomy and all of these patients underwent reconstruction with Pectoralis major myocutaneous flap. Ten patients underwent class 2a maxillectomy and reconstruction with obturator and Split skin thickness grafting. Nine patients underwent class 3a-b resection and four patients class 4a-b resection and all had reconstruction with temporalis myofascial flap. Two patients underwent orbitomaxillary resection with palate preserved and reconstruction with temporalis myofascial and forehead flap. Mean follow up period was 8 months (Range 6- 24 months). Two patients developed moderate grade of trismus after completion of radiotherapy.  One patient developed recurrence in neck after 6 months of completion of adjuvant radiotherapy. All had moderate to fair speech and eating function which improved over time.Conclusions: There was no difference between flap reconstruction or obturator intervention of maxillary defects in speech and eating function. Small and lateral defects are better reconstructed with obturator and defects involving orbit and total maxilla are better reconstructed with regional flaps. Hence even in the era of microvascular flaps, obturator and regional flaps can still be considered for reconstruction of maxillectomy defects with fairly good outcome

Role of staging laparoscopy to evaluate feasibility of performing optimal cytoreductive surgery in epithelial ovarian cancers

Background: The main stay of treatment for epithelial ovarian cancers is surgical cytoreduction. CT scan and staging laparotomy are methods used to assess feasibility to carry out optimal cytoreduction. We evaluated the role of staging laparoscopy in assessing operability for optimal cytoreduction as well as avoidance of unnecessary laparotomies.Methods: Between September 2014-2016, 23 patients of epithelial ovarian cancer underwent staging laparoscopy as part of evaluation method to check feasibility to carry out optimal cytoreductive surgery. The findings were correlated with clinical findings as well as CT scan findings. The impact of laparoscopy to predict operability was studied as well as its use to avoid unnecessary laparotomies.Results: Laparoscopy could correctly evaluate the nature of abdominal mass in 91.3% patients. It picked up omental and peritoneal deposits in 87% and 95.7% patients respectively as compared to 60.9% and 39% picked up on CT scan. More importantly laparoscopy could diagnose mesenteric and small bowel deposits in 34.8% of patients which were never reported on CT scan. The overall impact was reduction in unnecessary laparotomies.Conclusions: Laparoscopic evaluation is a useful adjunct prior to performing a formal laparotomy in epithelial ovarian cancer cytoreductive surgery

Active surveillance of adverse drug reactions in patients with rheumatoid arthritis in a tertiary care teaching hospital

Background: Drugs used in the treatment of rheumatoid arthritis show significant toxicity and morbidity. The objective of the study was to evaluate the nature and incidence of adverse drug reaction in patients with rheumatoid arthritis on anti-rheumatic drugs and to assess the causality and severity of the documented adverse drug reactions.Methods: The prospective observational study was done for two months in rheumatology outpatient department. All patients were interviewed for basic details, treatment history and adverse drug reactions and were recorded. Causality assessment and severity assessment of the recorded adverse drug reactions were done.Results: About 283 patients attended the rheumatology out-patient department during the two months period out of which 57 patients had one or more adverse drug reaction. The incidence of adverse drug reaction observed in rheumatology out-patient department to anti rheumatic drug was 20.14%. A total of 145 adverse drug reactions were noted in 57 patients. The most common adverse drug reaction reported was epigastric pain (6.89%) followed by headache and dyslipidemia (6.25%). The most common system associated with adverse drug reaction was gastrointestinal system (29.66%) followed by central nervous system and cardiovascular system (15.86%). Reported adverse drug reactions were assessed for causality and maximum belonged to probable (66.9%). Severity assessment revealed that most of the adverse drug reactions were mild (74.48%) in nature.Conclusions: Active surveillance for adverse drug reactions to anti rheumatic drug in patients with rheumatoid arthritis will allow early detection of adverse drug reactions and timely intervention to provide maximum benefit to the patients

Comparison of short-term outcomes following open and laparoscopic resections for colorectal malignancies

Background: The laparoscopic approach for colorectal cancers are still a matter of controversy. In the present study, we tried to compare the laparoscopy with open methods of colorectal resections.Methods: Retrospective study where patients diagnosed with colorectal cancer in our hospital from year 2014 January to December 2016 were taken. Total number of cases were 69 of which, the total number of right colon cases were 26. Out of twenty-six, 12 underwent open procedure and 14 underwent laparoscopic resections. Total number of left colon cancers were 09. Of these, 2 underwent open and 7 underwent laparoscopic procedure. Thirty-four (34) rectal cancers were included in the study. Of these, 12 underwent open rectal procedures and 22 underwent laparoscopic resections. Multiple parameters like duration of surgery, post-operative complications, postoperative stay, pathological T staging, lymph node yield, positive nodes, distal resection margins, circumferential radial margins were compared.Results: Operating time was significantly shorter in open procedure than laparoscopic surgery in both rectal resection and right hemicolectomies. The postoperative stay was significantly shorter in laparoscopic right hemicolectomy compared to open procedure. All other parameters like post-operative complications, T stage, lymph node yield, positive nodes, distal resection margins and CRMs were comparable in both groups. The lymph node yield was similar in upfront and post neoadjuvant carcinoma rectum cases.Conclusions: Laparoscopic colorectal resections have similar rates of complication, with shorter hospital stays with no compromise on oncological clearance with respect to lymph node yield, CRMs, distal resection margins compared to open procedures

Generic local distinguishability and completely entangled subspaces

A subspace of a multipartite Hilbert space is completely entangled if it contains no product states. Such subspaces can be large with a known maximum size, S, approaching the full dimension of the system, D. We show that almost all subspaces with dimension less than or equal to S are completely entangled, and then use this fact to prove that n random pure quantum states are unambiguously locally distinguishable if and only if n does not exceed D-S. This condition holds for almost all sets of states of all multipartite systems, and reveals something surprising. The criterion is identical for separable and for nonseparable states: entanglement makes no difference.Comment: 12 page