Introduction headache is one of the most common symptom and collectively headache is among the most common symptom of the neurodisorders, however there might be several reasons behind different sort of headache, headache can also be classified as 1. Odontogenic headache 2. Non odontogenic headache Case report: Here we are going to discuss an unusual case report of headache. A middle aged Asian male presented with headache in the department of cardiology with a history of migraine of 20 years ago and he was suspecting the headache because of high bp 90/ 160. He was prescribed with Ace inhibitors. Still he was suffering from daily persistent headache with pain intensity 4/10. Subsequently he was suggested to see the neurologist. the patient was without any red flag sign, head and neck examination was normal. This headache was always worsen in the evening and night hours, after taking calcium channel blockers headache was relieved for several hours but again started in the early morning hours. This was wakening headache. This headache was also relieved after maintaining cross ventilation in the room. Headache was unilateral, never crossed the midline, intensity varied from mild to severe shooting pain, worsened by hot and cold winds directly or indirectly on the head. Patient also had acupressure therapy on yin tang and tai-yang acupoints but he can't get a stable relief. Conclusion: Careful and thorough history taking skills are the key points for diagnosing exact cause and origin of a headache. It may reduce useless financial burden in the stable treatment of headache.

Body fat is regulated by a complex neuroendocrine system, making it difficult to maintain weight loss achieved via caloric restriction. Bariatric surgery produces greater weight loss and weight loss that is more durable than caloric restriction, and therefore is currently the most effective therapy for obesity. Sodium-glucose-co-transporter inhibitors are glucose lowering drugs that reduces plasma glucose levels by inhibiting glucose and sodium reabsorption in the kidneys, resulting in glycosuria. Sleeve gastrectomy is one such bariatric surgical procedure that involves the creation of a reduced stomach lumen along the lesser curvature of the stomach through the removal of gastric tissues along the greater curvature from the fundus to the antrum. Stomach capacity is typically reduced 80% or more, and the intestine remains intact. This procedure produces dramatic weight loss in humans and in rodents. In fact, recent reports indicate that its efficacy is close to that of the more common Roux-en Y gastric bypass. There are many diverse factors on which operative mortality of bariatric surgery depends such as facility related, surgeon related, followed by patient and procedure-related. To minimize operative mortality, specific factors were considered for the specific patients. As a result, to treat type 2 diabetes in association with obesity, slightly obese patients or overweight patients were treated with conventional bariatric procedures worldwide. For the management of morbidity obese diabetic patients, there is no single or standard procedure. Mahmood. Effect of SGLT in type 2 diabetes and gastric bypass surgery -a narrative review.

Introduction: Pilon fractures are major group of fractures around the ankle which involves the lower end of tibia bone that forms the ankle joint by articulating with the talus. It is also known as plafond fractures. Posterior pilon variant fracture is characterized by the involvement of both posterolateral and posteromedial malleolar fragment. The aim of this study was to assess the outcome using posterolateral surgical approach in posterior tibial pilon variant fracture using buttress plate.

Test suite optimization is an effective method that is used to minimize or reduce the time and cost of testing. There are several researchers and software professionals have used this method or techniques to enhance the correctness and effectiveness of test suites/cases. These approaches optimize test suite for a single objective but fuzzy logic with certain algorithm is used to optimize the test cases/suites for multi objective selection processes. Therefore, in the present work an approach of optimization or minimization of test suites is proposed for the designed fuzzy object-oriented database and also applied this approach to reduce the complexity of the designed database. The main objective of our approach is to minimize and find the test suite that is best optimal for multiobjective testing.

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