COPD and GERD more commonly diagnosed and frequently reported health issues due to overlapping pathophysiological mechanisms and now considered as ‘two sides of same coin’. COPD related anatomical changes and medications will alter the course of existing GERD and increase the risk of new onset GERD. Proximal and distal anatomical locations of GERD have variable presentations such as worsening of COPD, acute non-infective exacerbations, recurrent cough, and respiratory failure. Proximal pathways involve direct lung injury by means of microaspiration of gastric contents and microbiological colonization. Distal pathway involves indirect mechanisms by sharing common anatomical and embryological developments with involvement of vagus nerve mediated noradrenergic cholinergic mediator’s related effects on bronchi and bronchioles. Both proximal and distal pathways have effects on lung functions. GERD has negative impact on natural course of COPD and exists in asymptomatic and symptomatic types. Prevalence of GERD should be actively sought in all COPD cases to prevent exacerbations, decrease lung functions decline, lower the risk of clinical and physiological worsening, and overall cost of care because of these high index issues. PPI therapy has significant effects on patients with COPD in reducing the number of acute attacks, adverse reactions, and mortality. Recurrent exacerbations need GERD to be ruled out in all cases of COPD to have successful treatment outcome. Only symptomatic cases treatment has shown positive outcome in GERD with COPD. Hence, ‘to be or not to be is the real question’ and no treatment is recommended for asymptomatic GERD cases with COPD irrespective of disease severity.

Community acquired pneumonia is the most common cause for lung parenchymal infiltrates in chest radiograph in scenarios with acute febrile respiratory illness. Tuberculosis in India accounts for the highest number of cases and deaths in the world. In spite of an efficient National tuberculosis control program for five decades, Tuberculosis is still the number one cause of death due to infectious agents in India and one third of total global deaths occurs in India due to this disease. Tuberculosis may present with consolidation, cavitation, coin lesion, parenchymal infiltrates and hilar mass like lesions. Acute febrile respiratory illness without typical constitutional symptoms is not frequently described in pulmonary tuberculosis. In this case report, a 69-year male, presented with acute febrile respiratory illness of short duration. He was having high grade fever, cough, shortness of breath & haemoptysis of less than two weeks duration. His symptoms were progressive and empirically treated as lower respiratory tract infection or community acquired pneumonia with oral and intravenous antibiotics by general physicians and family physicians. Family physician referred to our center for worsened general health with increased shortness of breath with episodes of minimal haemoptysis. Chest x-ray documented right lower lobe consolidation which has progressed to central cavitations and thick pericavitary rim of consolidation mimicking lung abscess. Clinically he was having crepitations in the right inframammary and infrascapular area with egophony heard. HRCT thorax showed consolidation with cavitation in the superior segment of the right lower lobe and adjacent small cavity in the posterior segment presenting as a ‘Sister cavity’ accompanying a large parent cavity. He was unable to produce sputum and we have processed induced sputum examination which has documented acid-fast bacilli in smear and MTB genome with rifampicin sensitivity in cartridge based nucleic acid amplification test. Initially, microbiologists refused for smear preparation due to salivary nature and poor-quality sputum. We have insisted for microbiology workup due to high chances of yield due to cavitary lung disease and noted positive yield. Treatment initiated with anti-tuberculosis (ATT). We have recorded near complete radiological resolution, bacteriological cure after eight months of ATT with good compliance. Acute febrile respiratory illness and absence of typical constitutional symptoms is not uncommon. Although cavitating consolidation is commonly described in community acquired pneumonia, presence of ‘sister cavity’ is a radiological clue to think and proceed to workup towards active pulmonary tuberculosis. Induced sputum has a very significant impact on diagnostic yield. Pulmonary tuberculosis should be suspected early in cases with cavitating consolidations to have a successful treatment outcome.

Lung malignancies have diverse radiological presentations such as coin lesions, mass lesion, hilar abnormalities, lung collapse and mass with pleural effusion. ‘Coin lesion’ radiologically defined as solitary, well demarcated, coin shaped lung parenchymal opacity with surrounding normal lung parenchyma. Coin lesions having propensity of calcification and cavitation. Calcification usually indicates benign nature while cavitation will indicate benign, infective and malignant lung pathology. Eccentric cavitation favours lung malignancy and central cavitation usually seen in infective pathology over malignancy. Round pneumonia is commonly described in paediatric cases and adults with comorbidities. Round pneumonia is defined as a round shaped consolidation secondary infective process. Tuberculosis causing round pneumonia and coin shaped opacities or coin lesions are not very commonly described in literature. In this case report, a 42-year male, uncontrolled diabetes mellitus presented with constitutional symptoms for one month duration with partial response to medical treatment. Chest x-ray showed coin lesion or coin shaped opacity in the left lower zone in the paracardiac area. HRCT thorax showed coin lesion with central breakdown or central lucency and round pneumonia. Contrast CT thorax showed eccentric cavitation with enhancement favouring malignancy. We have done bronchoscopy and BAL evaluation confirmed pulmonary tuberculosis. BAL cytology documented acid-fast bacilli in smear and MTB genome with rifampicin sensitivity in cartridge based nucleic acid amplification test. Treatment initiated with anti-tuberculosis (ATT) & short acting insulin according to blood sugar level. We have recorded near complete radiological resolution, bacteriological cure after six months with good compliance. High index of suspicion is must in cases with ‘coin lesion’ in chest radiograph with underlying comorbidity as diabetes mellitus with constitutional symptoms. HRCT thorax will help in defining characteristics of coin lesions such as cavitation and calcification. Bronchoscopy is a very crucial technique in evaluating these cases and conforming infective or malignant pathology for coin lesions.

Since the 1970s, our society has been undergoing rapid digitalization. This has been paralleled by rapid advancements in biology, in particular with the sequencing of the human genome and the development of proteomics and metabolomics. This digital world presents an unmatched opportunity to revolutionize health. Today, genetic medicines deal with patients who have inherited diseases. Tomorrow, we will be able to deal with a much larger scope, including the multigenic susceptibility to disease. This is the promise of precision medicine. Cancer is a major focus of precision medicine. Initiative and developments in precise and effective treatment could benefit many other chronic diseases. Precision oncology focuses on matching the most accurate and effective treatment to this individual cancer patient based on the genetic profile of cancer and the individual,(Precision Medicine the Foundation of Future Cancer Therapeutics - Google Search, n.d.). Because every single cancer patient exhibits a different genetic profile. It can help make more accurate diagnosis and improve treatment that can help people to make decisions regarding their own health and they can deal with areas of uncertainty that might have lowered their risk of cancer.

Purpose: To investigate the effects of hybrid nano (Tio2 – Al2o3) addition on maxillofacial silicone elastomer mechanical properties. Methods: A total of 70 samples were prepared and divided into 7 groups; control, 1% Tio2 (nano-titanium oxides), 2% Tio2, 1% Al2o3 (nano-alumina oxides), 2% Al2o3, 0.5% Tio2-0.5% Al2o3, and 1% Tio2-1% Al2o3. which was added to silicone elastomer. Samples were exposed to artificial weathering for 250 hours, then tested for tear strength and roughness tests. The data were analyzed using a one-way ANOVA to determine the differences between groups. Results: After artificial weathering, a high increase in the mean value for tear strengths with an acceptable increase in the mean value for roughness was observed in samples containing 2% Tio2, followed by the samples with a hybrid of 1% Tio2-1% Al2o3, compared to the control and other groups. Conclusions: The addition of Tio2, Al2o3, and hybrid nanoparticles addition to maxillofacial silicone improved its mechanical properties. Hybrid nanoparticle filler reinforcement is encouraging for enhancing tear strength and roughness properties values for the longevity of maxillofacial silicone.

The policy of "double reduction" clearly requires that primary and secondary schools should carry out a variety of popular science, style, art, labor, reading, interest groups and community activities. However, the present situation of extracurricular sports activities in primary and secondary schools in China is not optimistic. Through research, it is found that there is a common problem of "rigid content and form" in extracurricular sports activities in primary and secondary schools in China, and students feel boring and have low enthusiasm for participation. "Children's Fun Track and Field" is a track and field sport that integrates running, jumping and throwing according to students' physical and psychological characteristics. It integrates sports and entertainment, and the forms and contents of sports events are rich and more interesting. Therefore, under the background of "double reduction" policy, it is particularly important to vigorously develop children's interesting track and field events in extracurricular sports activities in primary and secondary schools in order to enrich the content and form of extracurricular sports activities in primary and secondary schools, stimulate students' interest in extracurricular sports activities and improve their enthusiasm for participating in activities. Research methods: By using the method of literature, we know the current difficulties and shortcomings of extracurricular sports activities in primary and secondary schools, as well as the origin and content of children's interesting track and field. Research conclusion: Extracurricular sports activities in primary and secondary schools in China are currently facing the dilemma of single content and form, which can be alleviated by developing children's interesting track and field in extracurricular sports activities in primary and secondary schools. The research suggests that the traditional track and field sports such as walking, running, jumping and throwing should be improved appropriately, so as to enrich its form and content and add interest, thus stimulating students' interest in extracurricular sports activities, improving students' enthusiasm for participating in activities, forming good physical exercise habits and promoting the healthy development of body and mind.

Objective: To identify the relationship between the expression of IMP3 in benign and malignant tumors of salivary glands and other clinic-pathological variables. Materials and Methods: Twenty-six cases of salivary gland tumors were collected from the histopathology department, Gazi-Hariri hospital/ Baghdad Medical City from January 2021 to June 2021. Patients’ reports were included for diagnosis and clinicopathological data. Three histological sections were taken from the paraffin blocks for each case. The first section was stained with H&E stain, and the other two sections were stained with IMP3 (Dako-code M3626) monoclonal antibody by the immunohistochemical method. Results: Twenty-six cases of salivary gland tumor, with equal male/female distribution; the mean age for the patients was 45 years (19-60 years). There was no significant relationship between gender (P=.0.115), tumor size (P=0.359), tumor location (P=0.335), and tumor type (P=0.673) with positive expression of IMP3. Regarding malignant cases, no significant relation between IMP3 expression and tumor stage (P=1.000), and lymphovascular invasion (P=1.000). On the other hand, there was a highly significant relationship (P=0.000) between IMP3 expression and cell type (epithelial/mesenchymal). Conclusion: Imp3 might not be conclusive in differentiation between benign and malignant salivary gland tumors. Further studies with follow-up are needed to assess the prognostic value of this marker in salivary gland pathologies.