Scrum is a well-known agile model due to its strong management practices. It can be mingled with many software development models such as extreme programming (XP), Agile Unified Process, and Feature Driven Development (FDD). Lean is a very popular known process in the automobile industry due to its effective practices such as Kanban bard and smooth workflow. Lean development is gaining popularity in the software industry from the last few years. Lean development is rational, convenient, responsive, and team-based and it adds value to the enterprise. Scrum is useable and practical for small and medium projects but it does not render positive support for the large size projects. In order to adopt Scrum for large size projects, there is a need to integrate Lean and Scrum. It is required to inherit some properties of the Lean into Scrum, without compromising the speed, quality, efficiency, and standards, to accomplish large size projects successfully such as enterprise resource planning (ERP) systems. It is anticipated that the proposed Lean Scrum integration will make it suitable to develop large size projects. The same is accomplished by purposing an integrated LScrum model in this research. The proposed model is validated using a survey to conclude the results. The results of the survey support the proposed integration of Lean and Scrum for the development of large size projects.

Objective: To determine anesthetic efficacy of single buccal infiltration of 4% articaine and 2% lignocaine in extraction of maxillary 1st molar. Study Settings: This study was carried out at The Department of Oral & Maxillofacial Surgery, Bakhtawar Amin Medical and Dental College, Multan from March 2021 to August 2021. Material and Methods: Patients were divided in two groups randomly Articaine HCl. 4% with Epinephrine 1:100,000 injection and Lignocaine HCl. 2% and Epinephrine 1:100,000 injection. Buccal infiltration was given in the area between the two molar buccal roots, along the long axis. One person carried out all injections by using slow injection method (roughly 1ml/min) and deposited full cartridge (1.8ml of solution). 4% articaine or 2% lignocaine was used on each patient when extraction was performed however in cartridges labeled 1 to 100 with the use of suitable blinding technique. Results of the Study: VAS scores after injection of lignocaine were: mild for 5 patients (10%), moderate for 34 patients (68%), and severe for 11 patients (22%), while none of the patients reported with no pain after lignocaine injection. The mean pain experienced by patients on VAS, after extraction using articaine was 2.70 ± 1.91 and VAS after extraction using lignocaine was 2.58 ± 1.94. Conclusion: It was concluded that during articaine single buccal injection observed pain is significantly less in contrast to combined buccal and palatal lignocaine injection.. Keywords: Single buccal infiltration, articaine, lignocaine, maxillary 1st molar