Cleft of lip and palate are most common serial congenital anomalies to affect the orofacial region . It can occur isolated or together in various combination and/or along with other congenital deformities particularly congenital heart diseases. .Patient with oro-facial cleft deformity needs to be treated at right time and at right age to achieve functional and esthetic well being. Successful management of the child born with a cleft lip and palate requires coordinated care provided by a number of different specialties including oral/maxillofacial surgery, otolaryngology, genetics/dysmorphology, speech/language pathology, orthodontics, prosthodontics, and other. This article aims to the review the point primary care physicians in literature knowledge about cleft lip and palate. A review of literature have made to discuss introduction, epidemiology, clinical feature, etiology factor and management of cleft lip and palate.

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Childhood obesity is multi factorial health condition, so the simple evaluation of body fat will not be sufficed to manage the global epidemic of childhood obesity. Literature consistently provides evidence for physical health risks associated with childhood obesity; however in recent times, mental health of the obese children has also gained attention of the researchers as well as clinicians. Obese children experience number of psycho-social problems that significantly affect their quality of life and wellbeing. Co-morbid psychosocial and emotional problems of obesity generally act as causal or maintaining factors of obesity and thus significantly affect the treatment outcome. Therefore it becomes imperative for the clinicians/pediatricians to broaden their clinical assessment and include screening of important psycho-social factors within the clinical examination of childhood obesity. This article provides an evidence based comprehensive overview about the psychological factors and psychiatric factors (depression, anxiety, eating disorder, stress, body shape concerns, low self esteem) associated with childhood obesity that can further be utilized in the evaluation and management of this epidemic. The article also elaborates the role of current evidence based psychological approaches such as Cognitive Behavior Therapy (CBT) for management of obesity in children and adolescents. CBT techniques combined with lifestyle intervention and involving parents have been recommended by literature repetitively. However, there are a number of environmental, familial and personal barriers that hinder the whole process of weight loss in children. The article also discusses potential strategies to overcome those barriers.

This paper presents a similarity coefficient based approach to the problem of machine-component grouping. The proposed method incorporates relevant production data such as part type production volume, routing sequence and unit operation time in the early stages of grouping decisions for cellular manufacturing. The algorithm also suggests a methodology for evaluating alternative solutions from different algorithms on a quantitative basis using a modified version of an existingcoefficient. The modifiedquantitative measure is a comprehensiveindicator for the goodness of a grouping solution. The algorithm then identifies bottleneck machines and corresponding cell candidates for their duplication using percentage utilization in each cell as a criterion. Finally, additional constraints can be applied to determine the best grouping solution among alternative solutions generated by the algorithm. Asoftwarepackage has beendeveloped to verify the implementation.

DEDICATION This thesis is dedicated to my mother, Smt. Saroja. Her constant moral support, encouragement, and unselfish sacrifice of time over the years have enabled me to complete this research study and my master's degree. ACKNOWLEDGEMENTS The greatest debt of all is owed to my father, Sri. Nainar. His never-ending support and guidance are greatly appreciated. I am also deeply indebted to my wife, Mythili, and children, Krishna and Rathish, for their confidence that I would finish my thesis and graduate in the U.S. I express my sincere gratitude to Dr. Tarun Gupta, my thesis committee chairman, for requiring me to set deadlines and for making himself available to discuss content as well as general research procedures. He also played an instrumental role as teacher and guru in helping me envision the career I desire as an industrial engineer. I was fortunate to have Dr. Richard Munsterman as my advisor, to whom I am deeply grateful for his understanding, support and guidance throughout my graduate training and in the completion of this thesis. I am particularly indebted to Dr. Larry Mallak, who provided careful editing of the manuscript for consistency, appropriate substantive comments, and timely response. Also, I wish to thank The Graduate College of Western Michigan University for the grant that partially funded the research project.