What Does Low Business Confidence Mean

Low business confidence really means that businesses are operating from a fear principle instead of optimism. Firms worry about what might happen if there is a global economic meltdown. They lay off staff and shelve any plans they had for expansion. The trouble is that when enough companies do this it impacts on the global economy even more and becomes a self-fulfilling prophecy of gloom.

It’s all very well to point out that a national survey recorded confidence has fallen from the previous weak 21 index points to a record of -29, the weakest since 1997 when records were first taken. But take note that this was a survey of only 400 firms. Certainly the global economy has taken a beating – mainly due to people’s greed to start with. But businesses have lost confidence in the future mainly because they don’t know what effects the current global shock will have.

Maybe companies should start to think along the lines of the economy starting to improve, rather than getting worse. That’s what the National Australia Bank (NAB) has predicted – a slight increase over the next few years, while the Reserve Bank is even more optimistic, predicting a even stronger growth. With world powers all working hard to keep the economy from going up in flames it must certainly begin to improve before long.”

Prosthodontic Management of Ectodermal Dysplasia with Iliac bone graft and endosseou

Illica crest bone graft Ectodermal DysplasiaProsthodontic Management of Ectodermal Dysplasia with Iliac bone graft and endosseous implants : A case report

Dr Neeraj Nagpal , Dr K L Gupta, Dr Ruchi Nagpal, Dr Dhruv Sharma

ABSTRACT : Ectodermal dysplasia is a rare congenital disease that affects several ectodermal structures . Persons suffering from ectodermal dysplasia may have various manifestations of the disease that differ in severity and may or may not involve teeth, skin, nails , seat and sebaceous glands. The most common form of ectodermal dysplasia syndrome is hypohidrotic ectodermal dysplasia and is usually inherited as an X- linked recessive trait .Female carriers have a variable degree of clinical manifestations . This case report discusses prosthodontic management of an 18 year old female suffering from ectodermal dysplasia . Clinical management consisted of iliac crest autogenous bone graft to augment premaxilla . Later 2 endosseous implants placed in premaxilla and 2 endosseous implants placed in parasymphysis region of the mandible. After Osseointegration of the implants a four unit fixed partial denture placed in maxilla and an implant supported over denture fabricated for mandibular arch. Keywords : Ectodermal dysplasia , Christ Siemens syndrome ,Hypohidrosis , Hypotrichosis , Hypodontia . Introduction : Ectodermal dysplasia is a hereditary disorder manifested as dysplasia of tissues of ectodermal origin primarily nail, teeth skin and occasionally dysplasia of mesoderm derived tissues . As defined by Freire – Maia the nosologic group of Ectodermal dysplasia is any syndrome that exhibits at least 2 of the features ,that is ,abnormal hair (trichodysplasia ) , abnormal dentition , abnormal nails (onchodysplasia ) and abnormal or missing seat glands (dyshidrosis ) [1]. More than 150 different variants of Ectodermal dysplasia have been described [2]. Hidrotic and hypohidrotic are the 2 forms of Ectodermal dysplasia . In both types teeth and hair are similarly affected , but manifestations in nails and s eat glands and the hereditary pattern tend to differ [3] . The X- linked hypohidrotic form or Christ Siemens syndrome is characterized by clinical triad of hypohidrosis , hypotrichosis and hypodontia . Hidrotic form is inherited as an autosomal dominant trait and affects teeth , hair , and nails but usually spares the s eat glands .Prosthodontic rehabilitation is of paramount importance in patients suffering from Ectodermal dysplasia for functional , physiologic and psychologic reasons [1]. Case Report : An 18 year old female named Reena reported with multiple missing teeth since birth. Her parents reported in difficulty in getting her married due to poor look resulting from several congenitally missing teeth. After clinical and radiographic examination the case diagnosed as Anhidrotic Ectodermal Dysplasia . Family history of Ectodermal dysplasia as negative . The young lady as moderately built with hypotrichosis , scarce eyebrows and scarce eyelashes , dry anhidrotic skin , depressed nasal bridge , thin lips ,dark pigmented skin around periorbital area and nose , facial height as reduced ( fig . 1 ) She reported absence of eat and that her lips and tongue remain dry in all climates . There was no relevant effect on the nails . Intraoral examination revealed presence of partially erupted four teeth in the region of 13, 16, 23 and 26 ( fig 2, 3 ). The edentulous ridge as atrophic with decreased height . the palate as shallow , oral mucosa as normal and dry due to less saliva , the tongue as relatively large . OPG X ray depicted poorly developed premaxilla and completely edentulous mandible .( fig 4 ) Surgical and Prosthodontic Management Initially the impacted canine in the mandibular arch as surgically removed ( seen in the OPG fig 1 ). The ridge augumentation of the premaxilla was done with the help of an autogenious bone graft taken from the patients iliac crest( fig 2 ). Hence, the residual alveolar ridge made suitable for the implant placement .Three implants were placed in the mandibular arch in C,B and D positions , followed by the fabrication of an implant supported mandibular overdenture .

In the maxillary arch ridge the ridge augumentation was done with the help of a iliac crest graft Henceforth , a tooth supported fixed prosthesis i.r.t 24,25,26 as fabricated . Followed by the placement of 2 implants in the premaxillary segment .After three months of osseointegration , a four unit implant supported fixed prosthesis replacing 11 ,12 ,21 and 22 as fabricated .

An iliac crest bone graft as harvested ( fig 3 ) and stabilized to augment the premaxilla ( fig 5 ) .The iliac crest is preferentially selected because it is an autogenous cancellous bone graft and is easily harvested and has predictable acceptance and biointegration . After 2 months of bone augmentation 2 endosseous implants were placed in the augmented premaxilla( fig 6 ). Osseointegration of the implants as allowed for four months , followed by fabrication of four unit fixed partial denture prosthesis in 11, 12, 21and 22 regions. Impression as made using elastomeric impression material by putty ash technique .Abutment analogues and implant analogues were placed in the impression . The impression as poured in die stone by split cast technique. Later three endosseous double stage implants were placed in the mandibular arch ( fig 7 ). After four months of Osseointegration , the implants were uncovered , the abutments ere attached and a customized impression as made , after border molding , in rubber base impression material. The mandibular arch rehabilitated with implant supported overdenture ( fig 8 ) due to economical constraints and ease of rehabilitation .The denture as fabricated from heat cured P.M.M.A. (Trevalon powder and liquid , Dentsply ) .The intaglio surface of the denture as relieved and the female housings of the implant attached using autopolymerising acrylic resin P.M.M.A. (Dentsply ) There as marked improvement in speech and the facial esthetics . Discussion The treatment for a patient of Ectodermal dysplasia varies and generally depends on the persons age , dental agenesis , degree of malformation of teeth , the growth and development of the stomatognathic system of the patient and patient’s motivation . According to Nowak [1] treating the ectodermal dysplasia patient requires the clinician to be knowledgeable in growth and development , behavioral management , techniques in fabrication of prosthesis , the ability to motivate the patient in the use of the prosthesis and the long term follow -up for the modification and/ or replacement of the prosthesis . Prosthodontic treatment for ectodermal dysplasia includes removable partial denture or complete denture , overdenture and implants .These approaches may be used either individually or in combination to provide optimal results . Early prosthodontic treatment is generally recommended from the age of 5 years . This early restoration of facial appearance is essential for normal psychological development . [1] . Rapid growth in early life dictates the use of removable partial or complete dentures for these patients. When full growth is reached, treatment planning may include dental implants to retain, support, and stabilize prostheses. Osseointegrated implants offer an alternative that will provide major improvement in the long-term prognosis for oral rehabilitation. In treatment planning for implant dentistry in these patients, extra care must be taken to determine whether adequate bone level to receive the implants is present and whether there is adequate vertical dimension of bone to support the implants. Diminished bone volume may limit the success of implants, especially in the maxilla . The problems associated with complete denture placement in an ectodermal dysplasia case are mainly associated with periodic adjustment due to growth changes and difficulties in achieving good retention and stability [5] .Difficulties in achieving adequate resistance to lateral and anteroposterior displacement of the denture in hypohidrotic ectodermal dysplasia patient are due to dryness of oral mucosa and underdevelopment of maxillary tuberosities and alveolar ridges .[6] If few teeth are present in the mouth, overdentures are the most desirable treatment options [1,3].Overdentures help in preservation of the alveolar bone . Due to decreased number of abutments conventional fixed prosthodontic treatment needs to be altered . Dental implants may be placed in specific areas of the alveolar ridge to gain support for the FPD . For adult patients with ectodermal dysplasia , dental implants are the treatment of choice because growth has stabilized and implants may be used to support , retain and stabilize the prosthesis [1]. In this case of an 21 year old female and the premaxilla being poorly developed . Hence, an iliac crest autogenous bone graft used to augment the premaxilla followed by placement of 2 endosseous implants . The implants were later rehabilitated with a four unit porcelain fused to metal fixed partial denture . The treatment not only improved the patient- s functional and esthetic status (fig 7 ) but also improved the psychological wellbeing and the social life. Conclusion The study discusses the management of a young lady with Anhidrotic Ectodermal Dysplasia having multiple missing teeth and atrophic partially edentulous maxilla and edentulous mandibular ridge . A prosthodontic rehabilitation consisted of bone augmentation of premaxilla with iliac crest autogenous bone graft . Subsequently , 2 endosseous implants were placed to support a four unit fixed partial denture . An implant supported overdenture fabricated for completely edentulous mandibular arch . Hence , physical , physiological and psychological status of the patient as optimally restored . References 1.Pigno MA , Blackman RB ,Cronin RJ ,Cavazos E (1996 ) Prosthodontic management of ectodermal dysplasia :a review of literature . J Prosthet Dent 2.Pinheiro M ,Freire-Maia N (1994 ) Ectodermal dysplasias : a clinical classification and a casual review . Am J Med Genet 53 : 153- 162 3.Bonilla ED , Guerra L , Luna O (1997 ) Overdenture prosthesis for oral rehabilitation of hypohidrotic ectodermal dysplasia : a case report . Quintessence Int 28 (10): 657-661 Tarjan I , Gabrir K , Rozsa N (2005 ) Early prosthetic treatment of patient with ectodermal dysplasia : a clinical report J Prosthetic Dent 93 : 419-424 REFRENCES

1.Hickey A, Vergo JR TJ: Prosthetic treatments for patients with ectodermal dysplasia. J Prosthet Dent 2001;86:364- 368. 2.Guckes AD, Scurria MS, King TS, et al: Prospective clinical trial of dental implants in persons with ectodermal dysplasia. J Prosthet Dent 2002;88:21-25. 3.Dhanrajani PJ, Jiffry AO: Management of ectodermal dysplasia: a literature review. Dent Update 1998;25:73-75 4.NaBadalung DP: Prosthodontic rehabilitation of an anhidrotic ectodermal dysplasia patient: a clinical report. J Prosthet Dent 1999;81:499-502 5.Pigno MA, Blackman RB, Cronin RJ, et al: Prosthodontic management of ectodermal dysplasia: a review of the literature. J Prosthet Dent 1996;76:541-545 6.Blattner RJ: Hereditary ectodermal dysplasia. J Pediatr 1968;73:444-447 7.Davarpanah M, Moon JW, Yang LR, et al: Dental implants in the oral rehabilitation of a teenager with hypohidrotic ectodermal dysplasia: report of a case. Int J Oral Maxillofac Implants 1997;12:252-258 8.Bolender CL, Law DB, Austin LB: Prosthodontic treatment of ectodermal dysplasia. A case report. J Prosthet Dent 1964;14:317-325 9.Snawder KD: Considerations in dental treatment of children with ectodermal dysplasia. J Am Dent Assoc 1976;93:1177-1179 10.Guckes AD, Brahim JS, McCarthy GR, et al: Using endosseous implants for patients with ectodermal dysplasia. J Am Dent Assoc 1991;122:59-62 4. Sha RM (1990 ) Prosthetic management of hypohidrotic ectodermal dysplasia with anadontia : case report . Aust Dent J 35 : 113-166

Taking Advantage Of New Dubai Small Business Opportunities For A Profitable Venture In The Uae

If it’s your first time to dish out money for a small-scale venture in the UAE then here are some new opportunities you might want to look into before you get started with planning.

Imports and Exports

Small-scale entrepreneurs might want to try opening a trading company in Dubai to target import and export duties for fun and profit. Current market shows that there is a big market in importing foreign products and exporting local goods to countries, like Japan, United States, and China.

For example, pearl imports have seen a growth to 30% for this year alone which is a good opportunity for entrepreneurs who have contacts in the pearl industry. Import of construction materials are also in great demand due to the continuous constructions projects currently planned out for Dubai’s improvement. Exports of local products are also a profitable venture as well, especially if you target popular local goods, like medicines and ceramic tiles. Import and export of food products also yields profitable figures as well.

Recreational and Entertainment Establishments

Many new Dubai small business opportunities are mainly centered on recreational and entertainment facilities believed to be scarce in the city. The increasing number of tourists in the city, as well as the demand from local society has made it a profitable investment in opening up nightclubs, recreational kiosks, even entertainment hubs to target the needs of native UAE and foreign tourists alike.

Real Estate Investment

Real estate investment in Dubai has taken a turn for the better. New construction projects on various residential facilities and luxury homes are underway to target the need of local and foreign visitors. Trying your hand out in real estate as one of the potential new Dubai small business opportunities gives you enough leverage with the investment — offering you a risk-free acquisition. You can buy a real estate property to cater to local needs, or investment in many real estate properties for monthly rental or resell later on when prices yields to your favor.

Health Care

There is a huge need of professional health care workers in the UAE, especially in Dubai. As the city grows, hospitals and private institutions are in need of skilled nurses and care givers to cater to the needs of the locals. Such is the case, opening up a recruitment agency in the city as one of the new Dubai small business opportunities might be your ticket to success and profit. Investors with contacts with interested workers in other countries will do well in this industry, especially those catering to Child Care since this is considered to be a trend in Dubai’s current recruitment trend.

Travel Agency

One of the most lucrative new Dubai small business opportunities is in the travel industry. Many in the known-world are seeing Dubai as a tourist attraction and having a travel agency to cater to this trend promises a lot of profit on your way. This type of business requires you to be affiliated or familiar with various accommodations in Dubai, as well as in the rest of the UAE; tour options, recreational and entertainment facilities and services to cater to vacationer’s needs.

Getting Started

If you’re thinking if opening up a small-scale business in Dubai then you might want to stay away from Free Trade Zones due to financial issues. Opening up a sole ownership enterprise in the city might be too much to handle so the only option left for the investment is to set up an enterprise with native UAE sponsor as your partner. This way, you get to earn the profits while they take care of handling and managing the operation of the business.

Keep in mind, however, that you need a sponsor who is knowledgeable in the type of business you want to put up in the city. You can only take advantage of new Dubai small business opportunities if your local sponsor can give you accurate market trends and figures to help you plan it out. If you’re new to this venture then it would be best to have a local business consultant firm lend you their expertise to help you set things up from scratch.

Right Payroll Software Delhi and Its Merits for Business Management

Payroll management is an integral function which cannot be overlooked yet the traditional system of accounting did not serve the purpose in error free manner. Thus, buying payroll software from Delhi is a decision to be taken after analyzing its worth.

Protection of wages by managing it and its components proves to be an obligation for every business owner to ensure just payroll. To begin with, salary structure of all the staff members varies depending on their designation. Nevertheless, missing out any allowance or deduction while ruling out payroll, the glitches pertaining to calculations can prove to be major interruption in the mechanism of accounting officials! On the other hand, if these issues get neglected due to miscellaneous reasons, then, the entire episode can leave a negative impact on employees. Well, this can be avoided if ERP solution has been purchased by the company owner which compiles necessary modules those in totality make payroll management simplified.

Moreover, this software which is specifically developed for monitoring payroll and its constituents has absolute automated functioning. This in turn is a basic feature which lessens the burden of officials to a greater extent enabling them to make salary slips in most convenient way. In fact, payroll software Delhi has undergone improvisation several times and the best version which is available at present delivers advanced solution. The best part to be mentioned over here is the customization of software which can allow entrepreneurs to make the most out of its mechanism. Before actually proceeding with the finalization of best service provider based in Delhi, it will be ideal to take a look at points of significance those can influence your decision by and large:

USP of the solution has to be determined initially: Ever since payroll solutions powered by high-end technologies have emerged as resourceful yet when it comes to invest on highly advanced payroll management system Delhi, one has to check for its USPs. In other words, the whole idea is to select the solution of managing salary and its components after checking its promising nature that makes it superior as compared to others.

Chalk out your priorities to get tailored services: In case, pre-designed software of payroll available in Delhi does not meet your business targets effectually, then, you should identify the unique needs. After maintaining this checklist, you will be able to request for HR payroll software on the basis of the same rightly. However, you have to make sure your all the requisites have been presented forth the service providers appropriate so that they can offer profitable solution.

Ask the expert to avoid goofing up: In case, you are unable to take a final call with respect to finalization of payroll software Delhi, then, it is ideal to involve consultants. These experts will not just offer free demo of their software of payroll instead they even suggest the potential output. To cut it short, due to their immense experience in dealing with distinct business types, the consultants can recommend which variation of modules within the interface of payroll software will be beneficial for you.

On a whole, it can be affirmed that buying best payroll management system becomes quicker process, if all the aspects are borne in mind beforehand.

Payroll Software Delhi developed by HR Software Solutions is regarded as one of the best and easy to use software comprising of Payroll management system Delhi of both windows and web based modules.

How Can Yfmart Review Help You Decide On Women Clothing Wholesale

When it comes to women clothing wholesale then one of the names that you will often get to hear now is Yfmart. Yfmart is one of the leading names in Japanese and Korean womens clothing and it is doing great business by ensuring that it is providing the latest styles in womens clothing at amazingly low rates. When it comes to online fashion stores, Yfmart is making headlines all over the world. When you go through one or more Yfmart review you will know why it is so popular. Let us see how you can use these reviews to your advantage.

Advantage 1: the reviews are easily available
Any business today has an online footprint. Whether someone is a small or a large corporation, they ensure they have a website because they can generate more revenue by selling online than they can through their physical stores. As more and more people buy online they leave their comments where they judge the performance of the business. Hence, it is not difficult to find more than one Yfmart review to tell you why they are one of the leading names in women clothing wholesale.

Advantage 2: two types of reviews
You will find two types of reviews when you search for a Yfmart review. The first type is the reviews written by various experts. The second type is the reviews written by end customers. Both these types of reviews about this women clothing wholesale are important for you to go through because they give you different perspectives.

Advantage 3: reviews help you decide
You may be looking at buying wholesale clothes or cheap clothes womens or cheap women fashion but want to ensure that you are buying from a reliable source. Since there are thousands of online fashion stores it sometimes becomes impossible to decide which women clothing wholesale website to choose and which to ignore. When you go through a Yfmart review you get to know from the experts that the quality of their products is good and from the customers that their turnaround time and customer service is as per expectation.

It is not that every Yfmart review will be positive. There are bound to be some customers who will talk negative about the website. But if you look at the online reviews of any women clothing wholesale website you will find the same trend. What you will find is that most of the Yfmart reviews are positive. As a customer you would know that there are times when the provider, despite trying their best, cannot satisfy your expectations. The same thing happens with Yfmart. But most customers of this website are satisfied customers.

As you can see, a Yfmart review is not only easy to find but it also helps you perfectly decide whether you want to do business with them. It is no wonder that Yfmart has now created a name for itself in the women clothing wholesale online market. It is the positive reviews that have helped it get this name.