Conference Organised by Beyond Zero Campaign Assignment

Conference Organised by Beyond Zero Campaign - Assignment Example Daniel Steel was one of the speakers. He is an expert in laboratory tests especially blood test.   Therefore, he was an important speaker bearing in mind that Beyond Zero Campaign fight blood loss during childbirth. As a media personality from Sky news, He gave me chance for an interview after he was through with the speech. Steel is in his early forties and he is the C.E.O of blood test Clinix Company that is in Texas. The company involves itself in the business of blood testing. Medicine is not complete without blood analysis. When a doctor wants to check the status of your health such as to know the level of cholesterol or sugar in your body, blood testing must take place. The process usually requires needle and blood test tubes. The blood drawn from your veins into the test tubes go through testing in the laboratory by lab technicians. The biggest companies for blood testing in America are Quest and Laboratory Corporation of America. The two companies generate huge revenue and hence blood analysis is a lucrative business and steel was here not only to speak at a conference but also to drive his agenda of opening blood testing centres in Africa. â€Å"It is not expensive to test blood. It can be done fast and easily when the right tools are used†. Steel told his audience. While in the conferenc e, he had worn his working uniform to sound more convincing. He spoke systematically that everyone understood him. He started blood test Clinix Company with other medics 10 years ago at his young age of 23. Since then, the company has done well in the business and has developed many blood test methods. With only a drop or two, you discover many health conditions, whether cancer or any other. The blood centre is doing all it can to avail their blood test services to many hospitals. The idea of doing this is the help those who are far from the blood testing centre. Blood samples from the patient go from the hospital to the clinix lab. Discussions are underway for clinix to collaborate with as many hospitals as possible.  

Agency theory Essay Example | Topics and Well Written Essays - 1000 words - 1

Agency theory - Essay Example Freeman states that stakeholder concept is about management, and it mirrors and guides how managers function rather than chiefly addressing management and economists’ theories (1994). Freeman states two key enquiries of the stakeholder concept in his article. The first query is the aim of the corporation. This is useful and helpful for managers in the 21st century. Managers, by determining the purpose of the firm, can state the share’s responsiveness for the value they create. Managers can also determine what brings the key stakeholders together. Furthermore, this challenges the firm to establish sound performance through considering its goals and market fiscal metrics. The other question enquired in the shareholder concept is what accountability management has to shareholders. These aid managers to understand how they plan to carry out business. Predominantly, they look for a suitable kind of association with shareholders to attain their own welfares. The fundamental o f shareholder theory’s economic importance is that great numbers of persons come and function together to enhance their situation, in conformity with the central modern economic realisms. To urge more and more workforces to perform their finest for the corporations, it is essential and vital for supervisors to develop relations and create effective communication with shareholders. It is broadly accepted that stockholder is a significant party within the firm and his or her interests are a dire characteristic.

Cellular Respiration and Photosynthesis Essay Example | Topics and Well Written Essays - 750 words

Cellular Respiration and Photosynthesis - Essay Example All organisms that are doing photosynthesis help all living organisms who depend on them for food and oxygen. In the chemical reactions in photosynthesis, carbon dioxide and water combine with the help of sunlight to produce glucose (C6H1206 ). The chemical equation of this chemical reaction is 6CO2 + 6H2O + light = C6H12O6 + 6O2. Carbon dioxide is absorbed and oxygen is released. Photosynthesis occurs in the chloroplasts of photosynthesizers. There are two stages taking place in photosynthesis. These stages are the light dependent reaction or light cycle and the light independent cycle or calvin cycle. The main function of photosynthesis is to produce food and capture energy. There are also processes involved in photosynthesis. These are the production of organic carbon, glucose and starch, form inorganic carbon, carbon dioxide, with the use of ATP and NADPH produced in the light dependent reaction. This process can be seen in plants, protista or algae and some bacteria in the prese nce of chlorophyll. Light is absolutely essential to produce this reaction. On the other hand, cellular respiration is the biochemical pathway wherein cells produce energy for the chemical bonds of food molecules in order to produce energy needed to sustain life. Cellular respiration should be done by all living cells whether it is aerobic respiration which is in the presence of oxygen or anaerobic respiration. In this process, glucose is broken down into water, carbon dioxide and energy. This breakdown of food occurs in the mitochondria which releases energy. There are 4 stages involved in cellular respiration, Glycolysis, pyruvate oxidation, Krebs cycle, and oxidative phosphorylation. Like photosynthesis, ATP is also produces in this process, occurs in all living organisms. Unlike in photosynthesis wherein sunlight is needed, cellular respiration happens all the time and no catalyst is required. Oxygen is absorbed through this process and carbon dioxide is released. In addition to this processes, energy should also be understood. So, what is energy? It is the ability to do work and make things move. According to the Law of Thermodynamics, energy can be changed but is not created or destroyed. Due the inefficiency of energy transformation, energy is lost when we do activities. This can be explained by second law of thermodynamics which says that energy is converted to heat. This means that molecules that provide chemical energy should be replaced whenever our bodies use chemical energy in cellular processes. ATP or adenosine triphosphate is also needed to be understood. ATP provides the energy needed for all biological processes. ATP is produced in the process of cellular respiration. ATP is constantly produced by our cells and consumes energy from organic molecules like glucose. When ATP is broken down, energy is released. This is the energy used in synthesizing organic molecule, pumping ions through the cell membrane and muscle contraction. This explains ho w energy from food is used. This process starts when large organic food molecules like starch and triglycerides are broken down into small biological molecules such as glucose and fatty acids. These fatty acids travels in the blood and functions as an input for cellular respiration which transfers energy into organic particles such as glucose to energy in ATP. Afterwards, ATP is used to provide energy for cellular

The Insanity of Being Sane Essay Example | Topics and Well Written Essays - 1250 words

The Insanity of Being Sane - Essay Example Both of these writers shared the same experiences of being insane, cast out, and maltreated just to unveil and uncover the true situations inside the mental institutions in the nineteenth century and the present time. These two literary books are inspiring and reveal the continuity of how mental institutions have been dealing with the mental patients for centuries. Nellie Bly wrote â€Å"Ten Days in a Mad-house† somewhere in 1887. She was a newspaper reporter tasks to expose the brutality and neglect among the mental patient in the mental institutions. For ten days, Bly involuntarily committed to be lockup to the Blackwell’s Island insane asylum as she is saying that â€Å"My instructions were simply to go on with my work as soon as I felt that I was ready (Bly, N.)†. To be able to be admitted to the insane asylum, she had to check in a women’s boarding facility after which she acted irregularly. This instance ignited the whole plan for Bly to enter the fa cility (Time Staff, 2009). Just like Nellie Bly, Norah Vincent is also a journalist, a brave immersion journalist who lets her self-lockup in the insane facility for ten days. Both of the two writers immersed in an insane facility. However, Bly involuntarily accepted the task being drawn to her while Vincent was required to be confined at the asylum as the author narrated â€Å"On the advice of her psychologist she committed herself to a mental institution† (Vincent N. 2009). Moreover, after ten days, Vincent decided to get out of the asylum with the promised to her self not to get back again, as she said, â€Å"I got home a wreck, and swore that, no matter how bad I felt, I would never willingly go into such a place again, never†. (Vincent N, 2008). Bly was able to convince the authority of the asylum and be confined for ten days was well planned. Bly, at first, fabricated to be mildly insane and begin the whole process by convincing her roommates as well as the owner by standing the whole night at the wall, talking a lot to never seen people, and doing strange things. The things she does were found out to be sufficient to be in front of the judge and as expected, recommended to stay inside the asylum where she had manifested the arbitrary and the vindictive rules in the asylum (Bly N. (2009). On the Contrary, Vincent was able to enter the asylum because she was diagnosed to have a mental illness that started way back ten years ago. Vincent’s depression was developed to be a sickness until she had never any choice but to enter the asylum. Nevertheless, she battled her own problems and made it a way to discover and continue her pilgrim in writing and exposing what life she had gone through inside the asylum â€Å"As her treatment and her symptoms improve, Vincent warms up to the idea that â€Å"the bin† might not be all bad, and she softens in her critique† (Vincent, N. 2008). The way she helps her self in battling her misfor tunes have gone through the process of knowing her self, realizing where she was in, grasping the feelings about her situation, and how she can help her self to be out of the asylum, as Vincent states â€Å"I spent four lost, interminable days in lockup that first time in the bin, getting worse, weeping at the sealed windows, yelping for rescue through the pay phone in the soul-destroying dayroom.

The use of IFI replacing PRSP Essay Example | Topics and Well Written Essays - 1750 words

The use of IFI replacing PRSP - Essay Example It is a road map that leads the organizations involved in this process, to the making of the final PRSP. During the period in which the document is formulated, greater participation by the civil society is encouraged. The data that provides information on the nature of poverty and its distribution are collected and considered for statistical analysis. According to the IMF and the World Bank, the PRSP document must present an exclusive description of the participatory process for the making of the document, a comprehensive diagnosis of the problem of poverty, clear description of the social and economic priorities and transparent targets in accordance with the costs incurred by the society. The PRSP acts as an indicator of the monitoring system and helps in evaluating the process of progress (Christiansen and Hovland, â€Å"The PRSP Initiative: Multilateral Policy Change and the Role of Research†). ... This is because the process is highly context specific and the does not follow any pre determined critical pathway that would directly lead the government of the country to develop the PRSP (Christiansen and Hovland, â€Å"The PRSP Initiative: Multilateral Policy Change and the Role of Research†). The basic principle followed for the drafting of the interim PRSP is to follow the broad participation rate, engagement of the civil society as well as the private sector in deciding the structure of the expenditure and their priorities. Structural adjustment measures in Pakistan Pakistan has undergone a number of structural adjustment programs since the 1970s. The adjustment modification that was undertaken in the 1980s had brought improvement in the economic performance of the country and also made the common population capable of responding to the economic changes occurring in the economy of Pakistan. However, the focus of these structural adjustment lied solely on increasing effi ciency of economic activities in order to bring economic benefits, but, attention had not been given to the problem of rising income inequality. Incidence of poverty has grown over the years and at present there is huge inequality in distribution of income (James and Pyatt, â€Å"Three-Gap Analysis of Structural Adjustment in Pakistan†). These factors have necessitated the drafting of the Poverty Reduction Strategy Papers. The government (Finance Ministry of the Government) along with the civic bodies in the nation, individual participants and non-governmental organizations work in synchronization to develop the draft of the PRSP backed by the international financial institutions (IFI). The PRSP has been aimed at replacing the existing structural adjustment measures in the

Environmental Scan Paper Essay Example for Free

Environmental Scan Paper Essay For any company to survive in the business environment, they must be accustomed toward any situation within the environment because of certain issues, perceptions, chances, and resources. These are such reasons every business must observe any applicable changes, which can occur within the environment and invent from existing policies to adjust toward variations. For any company to succeed the company will need to conquer the trials and tribulations of the constant shifting environment. An environmental scan were conducted for the two following companies Starbucks, and Cocoa Cola. With the environmental scanning it will increase their chances and distribute their resources in the expectation of the constant changes within the environment. Starbucks was originated in 1971 in Seattle Washington on Pikes Place Market. Starbucks is a specialized whole bean, ground coffee, and tea business/distribution. Over the course of their years Starbucks until this present day builds relationships with millions of customers in over 17,000 stores all over the world. Starbucks are known in Argentina, Aruba, Australia, Austria, Bahamas, Bahrain, Belgium, Brazil, Bulgaria, Canada, Chile, China, Cyprus, Czech Republic, Denmark, Egypt, El Salvador, England, France, Germany, Greece, Guatemala, Hong Kong, Hungary, Indonesia, Ireland, Japan, Jordan, Kuwait, Lebanon, Malaysia, Mexico, New Zealand, Netherlands, Northern Ireland, Peru, Philippines, Poland, Portugal, Qatar, Romania, Russia, Saudi Arabia, Scotland, Singapore, South Korea, Spain, Sweden, Switzerland, Taiwan, Thailand, United Arab Emirates, United States, and Wales. As it has been read Starbucks are very much known all over the world. Of course Starbucks just is not about coffee, they are also specialized in more than 30 different blends of coffee both hot and iced. They also make smoothies (for the health conscious), and different variety of teas such as black tea, green tea, calm tea (herbal tea), and passion tea (herbal tea) just to name a few. Starbucks also sells pastries, sandwiches, yogurts parfaits, salads, fruit cups, and oatmeal. Of course they also make (which is what they are known for) the infamous Frappuccino. The internal environment of the Starbucks company is a representation of the general conditions, which affect their aptitude in executing a successful strategy. The internal elements are their growth of strategy (diversified portfolio), brand management, and human resources. The external environment of the Starbucks company are focused on competition, which are within the same business as them, legal and, political changes, opportunities such as environmental concern, and the demographic social issues such as income per household. Coca Cola one of the major producers, supplier, and vendor of the soft drink industry sells a variety of up to 35,000 different products ranging from their regular soft drinks, to clothing, and collectable toys. Coca Cola sells four of the five top selling soft drink beverages, which are Diet Coke, Sprite, Fanta, and of course, Coca Cola. The Coca Cola company also sell water, juices, and sport drinks. The internal environment for Coca Cola have key attributes, which include competence in the production method, from excellent communication and management skills. For the Coca Cola company to monitor their internal environment, they would need to evaluate the process, which by they can take action on the factors that would cause any kind of inadequacies on the phases of production. Such things as obesity, scarcity, and quality of water have changed the nonalcoholic beverage business, which include changes with consumer preferences based on health and nutritional research. Because of the research consumer taste and needs have changed and also because of the changes of the law and new regulations the Coca Cola company needed to adopt the additional warning requirements, and additional labeling for the warning requirements. Coco Cola understands that the external environment may affect the business and its revenues. The increases and decreases of the economy, the attitudes from consumers, the principals of the consumers, and the demographics of society have a big impact on Coca Colas revenue. Competitive Advantages and Current Strategies Starbucks Starbucks has contributed toward the green movement by informing the public they will only deal with the suppliers that meet the Starbucks standards for sustainable development. Starbucks understands the social influence and how it can ether force a change or contribute toward a change because the company understands that individuals are becoming more concerned with the preservation of the planet earth, which is why Starbucks have teamed up with the Green Team to established company wide recycling, reduction of waste, conserving energy, and conserving water programs. Another concern that Starbucks have taking into consideration are the publics growing concern of healthy eating habits. It is imperative for Starbucks to guarantee that their products are not labeled as unhealthy, so they have added more health conscious choices such as salads, smaller portions of pastry, and healthier liquid choices for the health conscious consumer who enjoys the Starbucks environment. Coca Cola Coca Colas strategy is to target the distinct market groups that are divided by competitive intensity and socioeconomic levels. They have implemented a planned product, pricing, and packaging strategy through certain channels of distributions so they can gain operational efficiency within the company. Coca Cola have used such events as the Super Bowl and the World Series to attract the consumers attention with their commercials. The customer surveys help the Coca Cola company with their marketing strategy and show, which adjustments would need fixing. Such marketing strategies such as phone surveys, social media, mail surveys, e-mail surveys, and text messaging assist the company on further marketing strategies on improving their revenue. Such things as market leadership, joint ventures, managerial expertise, inventive business solutions, and flexible organizational structure have giving Coca Cola a competitive advantage (Coca-Cola FEMSA, 2010). Coca Cola also provide managerial expertise training programs to improve their abilities, The inquiries for both companies on sugar content in the products have increased. Also there are negative doubts about their recipe of sugar content effecting weight control, pop culture, and society. Over the course of the years Coca Cola have adjusted their recipe because they are using crafty marketing and distributing smaller products so criticism can decrease on their products. To improve further recognition in Latin America the Coca Cola company have had joint ventures with companies in Mexico and Brazil. They also have plans on heightening engineering and supply capacity so they can boost operational effectiveness. References Business Unit. (2010). Retrieved from http://www.femsa.com/en/business/coca_cola_femsa/ Coca Cola . (2012). Retrieved from http://www.thecoca-colacompany.com/citizenship/energy_climate_protection.html Recycling and Reducing waste. (2012). Retrieved from http://www.starbucks.com/responsibility/environment/recycling Goals and Progress . (2012). Retrieved from http://www.starbucks.com/responsibility/global-report/environmental-stewardship

Techniques for Extraction of Impacted Lower Third Molars

Techniques for Extraction of Impacted Lower Third Molars Abstract Objectives: Many series of side effects will be produced with the extraction of impacted lower third molar which including pain, swelling, inflammation, and trismus. Flap design is important to allow good visibility, reach to the impacted tooth, and for healing of the surgically created defect. This study aims at the evaluation and comparison of standard flap design with comma type of flap design used in the surgical extraction of impacted mandibular third molar and to objectively evaluate the merits and demerits of individual flap design. Study Design: In this study 200 patient with bilateral mandibular third molars impaction of age group of 18-30yrs were selected for the study, To reflect the mucoperiosteal flap On one side standard incision and on other side comma incision were used and , after which the steps are common in the removal of impacted third molars. Immediately on the post –operative days 1, 3 and 7 the post– operative parameters (pain, swelling and mouth opening were recorded. And periodontal status were recorded pre operatively, 1st month and 2nd month respectively. Results Conclusion: The pain and swelling scores were found to be significantly lower in the surgical area with comma incisions which was recorded on days 1, 3 and 7 as compared to the the area where standard incisions were made. In mouth opening There was a sufficiently great difference seen between the two incisions on 1 post-operative day, but though there was clinical difference between the two incisions on day 3 and 7 there was no statistical significance. The results of the study shows no lingual nerve paresthesia or any other morbidity, hence the new incision design should probably be made the conventional method, considering the less degree of post operative complications encountered. although it may require some practice initially. Key words: Standard Incision, Comma Incision, Mandibular Impaction, disimpaction,Visual Analog Scale Clinical Implications:-third molar impactions are common and usually associated with postoperative complications like pain, swelling, trismus and pocket formation. Incision and flap design is important in healing wound and minimizing post-operative complications. Comma incision design has shown less post-operative complication in compare to standard incision Introduction: Impaction is defined as cessation of the eruption of a tooth caused by a clinically or radio graphically detectable physical barrier in the eruption path or by ectopic position of the tooth. at least one impacted third molar will be present in 33% of the population which requires surgical removal of impacted third molar hence disimpaction is the one of the most frequently performed procedure.1 Lower third molars constitute a major bulk of teeth that are impacted in the oral cavity2. Many series of side effects will produced with the extraction of impacted lower third molar which including pain, swelling, inflammation, and trismus 3. Flap design is important to allow good visibility, reach to the impacted tooth, and for healing of the surgically created defect. Many different incisions have been used to raise the flap, like Wards Incision, modified ward’s incision, envelope, ‘S’ shaped incision [Bould Henry] etc4. Ward’s and modified ward’s incision are more commonly used and it was observed that Wards and modified Wards incision provide excellent visual and mechanical access and can be closed by means of a suture inserted between the buccal and lingual soft tissues alone5 , However when a releasing incision is made a small buccal artery is sometimes encountered and this may be mildly bothersome during the early portion of surgery, and also the suture is usually placed on a bone defect and not on healthy bone this may cause additionally pain, delayed healing are also seen.6 Nageshwar has tried a new type of incision- comma shaped incision and has compared it with the modified wards technique (Figure 1). However the number of cases in his study were very less [n=15], hence this study was undertaken to compare this new comma shaped incision with wards incision using more objective and subjective parameters with a larger sample size. Material and Methods: 200 patients between the age group of 18-30yrs, having completely impacted bilateral mandibular third molars or partially erupted third molar, with good oral hygiene, without any symptoms of pain or swelling were included for the study. Patient on any medication, pregnancy, severe Pericoronitis, soft tissue impaction, medically compromised, Missing mandibular second molars was the exclusion criteria for the study and were excluded from the study. The instruments used to compare two flap designs were Williams probe to measure pocket depth. Visual analog scale of 0 to 10 was used to estimate pain by subjectively asking the patient to rate the nocioceptive experience7. Swelling was assessed by measuring by the distance between the: Tragus notch and a reproducible soft tissue pogonion a long the skin surface. Tragus notch to angle of mouth Tragus notch to ala base Tragus notch to outer surface on lateral wall of eye Angle of mandible to outer surface of lateral wall of eye The percentage difference between the postoperative and preoperative measurements was calculated. Mouth opening was evaluated by measuring the maximum inter incisal distance. After obtaining ethical clearance from the hospital ethical committee, written consent was obtained from all the patients who satisfied the inclusion criteria. Preoperative radiographs were taken to assess the position, depth and angulation of the third molars and to exclude any local pathosis such as a cyst, tumor etc. pain, swelling, mouth opening and pocket depth were recorded Preoperatively . One side of impacted mandibular molar is surgically removed under local anesthesia Using standard flap (figure 2). pain, swelling and mouth opening were measured Postoperative on day 1, 3 and 7 respectively. The extraction on the opposite side was done with the alternate flap design-Comma incision (figure 3). The follow up and postoperative complications of patients on day 1, 3 and 7 were recorded for the parameters studied. After flap reflection standard procedural steps were followed. Flap was sutured with 30 Braided silk sutures. Post operative instructions were given and patients with a standard antibiotic regimen of Cap. Amoxicillin 500mg TDS* 5days Tab. Ibuprofen 400mg TDS* 5 days Tab. Metronidazole 400mg TDS* 5 days Bilateral The pocket depth is recorded after month. Data management and Analysis The post-operative complications for each subject for both incisions were recorded and all data was entered in Microsoft Excel. Data was analyzed using computer software, Statistical Package for Social Sciences (SPSS) version 10. Data are expressed in its frequency and percentage as well as mean and standard deviation. To elucidate the associations and comparisons between different parameters, Chi square (à ¯Ã‚ Ã‚ £2) test was used as nonparametric test. Student’s t test was used to compare mean values between two groups. For all statistical evaluations, a two-tailed probability of value, Results: Out of 200 extractions done using ward’s incision 107 were non erupted and 93 were partially erupted, Out of 200 extractions done using comma incision 111 were non erupted and 89 were partially erupted, {table 1} In extractions done with standard incision 26.67%of subjects had severe pain on day 1 where as only 13.33% of subjects had severe pain on the exaction side done by comma incision. There is a high statistically significant difference between the two type of incision on day 1 in comparing the pain. (Chi -Square=15.627, P=0.0062) similarly the pain was severe for 6.67% of the patients extracted with ward’s incision and there was no pain on other side where comma incision was used on the 7th post operative day (Chi -Square=28.799, P=0.000) {Table 2} In extractions done with standard incision 46.47%of subjects had severe swelling on day 1 whereas only 33.33% of subjects had severe swelling on the exaction side done by comma incision. But the difference seen was statistically significant difference between the two type of incision on day 1 in comparing the swelling, (Chi -Square=2.4762, P=0.2889). the swelling was sever for 20% of the patient extracted with ward’s incision and there were no patient with sever swelling on comma incision side, (Chi -Square=8.6872, P=0.0365). on 7th day there were no patient with severe swelling in both the groups but 40%of the patients experienced moderate pain in ward’s incision group where as only 13.33% had moderate swelling in comma croup. There is a statistically significant difference between the two groups on day 7 (Chi -Square=18.879, P=0.0158).{Table 3} The mouth opening on day 1 in ward’s incision side is between 29-25mm where 33.33% where as only 13.33% of the patients in comma group. There was highly statistical significant difference between the inter incisal measurements to check for mouth opening on day 1 (Chi -Square=24.658, P=0.000). but though there was clinical difference between the two incisions on day 3 and 7 there was no statistical significance.{Table 4 } There is significant statistical difference between wards and comma incision in relation to pocket depth recorded after first month and the second month in first month is (t=2.684, P=0.025), and in second month is (t=4.937, P=0.000). and even when ward’s and comma incision are compared separately over time there was statistical significance between the pocket depth in first and the second month was seen, I’e (wards incision t=5.176, P=0.000) and (comma incision t=6.812, P=0.000) in second month. {Table 5} Discussion: Third molar surgery has been associated with a variety of complications, flap design is one important factor influencing the severity of these complications . The incisions used in surgical treatments of impacted 3rd molars can be grouped in to envelop and triangular varients.all incisions irrespective of there variations, were extended from the distal aspect of second molar towards ramus. These standerd incisions have been modified by many surgeons.the incision modified by Groves and Moore started distal to the distobuccal line angle of the second molar to conserve the periodonsium8. Berwick designed a lingually based flap using an incision line that was tongue shaped and did not lie over the bony defect.9. Comma shaped incision was designed by Nageshwar to limit the post operative pain and swelling. Post operative pain of moderate to severe intensity is usually noticed after third molar surgery, the pain usually begins as the effect of local anesthesia fades off. The peak intensity of pain is noticed after about 6 hours. The pain then disappears slowly within a few days if it heals normally.10 In our study, pain was assessed by using a Visual Analogue Scale (VAS) as it takes little time to describe to the patient and it is easily understood by the patient. The results showed less pain scores on comma incision side as compared to ward’s incision side which is similar to that of the study of Nageshwar. (This may be because small mucoperiosteal flap was elevated during comma incision, the drainage in comma incision is good and this is single flap hence it will give a tight closure on occlusal surface distal to second molar.) This result is not in correlation with the results of Gool et al as they have seen that severity in pain is not related to the type of incision.11 trauma and infection are the main cause for postoperative swelling. The truma to the tissues associated with oral surgical procedures is the usual cause of early postoperative swelling. It is most marked after 19-24 hrs and then diminishes after about seven days.12 Swelling in cases with comma incision was comparatively lees than cases with standard incision was done. This study results compliments the study by Nageshwar.1 but the method of measuring swelling was not satisfactory in that study because the swelling is three dimensional hence it is measured by marking on 6 different points on the face as described earlier. Salata L.A et al and Szmyd et al reported that restricted mouth opening peaks on the day of surgery. This study is in agreement to this statement too13. The comma incision encountered less number of subjects with limited mouth opening when compared with the standard incision side which is in agreement with the study of Nageshwar’s result The inter relation between trismus and pain have been reported in many studies. It might therefore be expected that mouth opening after the removal of impacted mandibular third molars is painful and consequently reduced to its full extent. The hypothesis has been confirmed by an electromyographic study which proved that restricted mouth opening is a voluntary action to avoid pain.14 There was a statistical difference in the postoperative probing depth between the two types of incision after the first and second months. These results are contradictory with many studies, by Rosa et al, Quee et al and Schofield et al which show no differences in pocket depth related to flap designs15. But A.A. Krausz, E.E.Machtei,M.Peled suggest that increased second molar pocket may be related to osteotomy16. However others believe that the flap design and the patients age might have an effect on second molar periodontal status. When removal of impacted molars was done during developmental stage of the tooth faster regrowth of the alveolar bone crest . However as all our subjects were in the age group of 18 -30 we feel that age was not a major factor and the difference in pocket depth is related to the type of flap. Conclusion: The results of the study shows that none of the patients in the study developed lingual nerve paresthesia or any other morbidity, hence the new incision design should probably be made the conventional method, considering the less degree of post-operative complications encountered. although it may require some practice initially. Further research with newer flap designs like the comma design, which will minimize the post operative complications, should be considered in the extraction of impacted third molar surgery.