Collision tumors of the thyroid gland are a rare entity. Primary squamous cell carcinoma of the thyroid (PSCCT) is a malignant epithelial tumor, composed entirely of cells with squamous differentiation and accounting for less than 1% of all malignancies of the thyroid gland. PSCCT arises from other thyroid diseases such as Hashimoto’s thyroiditis, tall cell variant papillary carcinoma, follicular carcinoma, and anaplastic carcinoma1. We describe a patient with the combination of a well-differentiated squamous cell carcinoma and follicular carcinoma of the thyroid.

Pre-pregnancy mother's body mass index plays a role in increasing or decreasing maternal weight. Maternal body mass index is a prominent indicator for the nutritional status of pregnant women who can be at risk of increasing the occurrence of births with low birth weight babies. This study aims to analyze the relationship between pre-pregnancy body mass index and the occurrence of low birth weight babies at Abdul Moeloek General Hospital Bandar Lampung, Indonesia. This study uses an observational analytic research design with a cross sectional approach. The population in this study were all post-partum mothers who gave birth at the Abdul Moeloek Regional Hospital in Bandar Lampung and involved a sample of 79 respondents who were taken using the consecutive sampling technique. Sampling was carried out based on inclusion and exclusion criteria that met the research criteria until the desired number of samples was met. Analysis of the research data is the chi-square test and logistic regression test. The results showed that the two independent variables, namely the pre-pregnant mother's body mass index and weight gain during pregnancy, had a significant relationship to the baby's birth weight. The significance of body mass index is p-value=0.004 and the significance of weight gain during pregnancy is p-value=0.000. Thus the body mass index of pre-pregnant women and weight gain during pregnancy can affect low birth weight babies at Abdul Moeloek Hospital Bandar Lampung.

Introduction: A relatively new type of ectopic pregnancy is cesarean scar pregnancy (CSP). This is related to the increasing number of cesarean deliveries and to the advances in imaging. There are 2 types of CSP; CSP with progression to cervicoisthmic space or uterine cavity (type I, endogenic type) or with deep invasion of scar defect with progression towards bladder and abdominal cavity (type II, exogenic type). The endogenic type of CSP could result in a viable pregnancy; yet with a high risk of bleeding at the placental site. The exogenic type could be complicated with uterine rupture and bleeding early in pregnancy. As early diagnosis and treatment is important for the best outcome, every pregnant woman with history of cesarean delivery should be screened early in the first trimester of pregnancy. Diagnosis can be achieved with ultrasound and Doppler imaging. To date there have been only 5 randomized studies on CSP and evidence based management remains unclear. Until then, treatment should be individualized according to many factors including clinical presentation, β-hCG levels, imaging features, and the surgeon’s skill. We report a case of cesarean scar pregnancy successfully managed in our university hospital center.

Background: Pregnant women are considered vulnerable to be infected with Covid-19 and it is feared that this will result in unfavorable conditions for the baby and mother. Pregnant women with Covid-19 require special attention and care, because the viral infection caused by Covid-19 does not only attack the mother, but also the baby and adversely affects the outcome of pregnancy. Objective: This study aims to provide an overview of the characteristics of pregnant women with Covid-19 and delivery outcomes at Abdul Moloek Hospital Bandar Lampung. Methods: Searching the medical records of pregnant women with confirmed COVID-19 who gave birth at the Kasih Ibu Hospital in Surakarta.data is presented in the form of a distribution based on gravida, parity, Covid-19 symptoms, degree of Covid-19 symptoms, and delivery outcomes. Results: A total of 104 pregnant women with confirmed Covid-19 delivery at Abdul Moloek Hospital Bandar Lampung. Respondents who gave birth had experienced pregnancy more than once and had given birth two to five times. Of all pregnant women, most experienced asymptomatic symptoms, and 11.5% mild symptoms, of which only 9.6% experienced severe symptoms. Outcome of labor was found not to have preterm delivery. Conclusion: Further research is needed on the transmission of Covid-19 from mother to fetus.

Polycystic ovarian syndrome (PCOS) is a complex condition. In PCOS the metabolic and endocrine components are affected. The PCOS is an evolving condition and therefore has variable ultrasound presentations. Inappropriate gonadotrophin secretion causes ovarian dysfunction. Increased level of plasma testosterone is a common feature in PCOS. Women with PCOS have abnormalities in the metabolism of androgens and oestrogen. PCOS is a genetically heterogeneous syndrome. The abnormal menstruation patterns in PCOS is attributed to chronic anovulation. Women with PCOS should be assessed for their cardiovascular risk. The lifestyle modifications such as reducing the weight, increasing the exercise and restriction of carbohydrate intake consistently reduce the risk of diabetes. Medical management of PCOS is aimed at the treatment of metabolic derangements, anovulation, hirsutism and menstrual irregularity. The surgical management of PCOS is aimed mainly to improve ovulation. PCOS has many long-term complications. Therefore the patients need regular follow-up with their physicians for early detection and management of any untoward sequelae associated with the syndrome.

Background: To contribute to a midwife's and nurse's career longevity, midwives and nurses working in today's dynamic, changing healthcare system need personal resilience, a strong sense of structural empowerment, and the necessary skills to respond to workplace challenges. The current study demonstrates the importance of the relationship between structural empowerment, resilience, and intent to stay. Method: A cross‐sectional, correlational design was utilized to achieve the aim of the current study. Result: The total sample size was 200 midwives and nurses. A Pearson's Product Moment correlation coefficient was used to predict the strength of the statistical relationship between the variables. There was a moderately strong relationship between structural empowerment and intent to stay; a low relationship between resilience and intent to stay and a moderately strong relationship between resilience and structural empowerment. Conclusion: The study concludes that structural empowerment, resilience, and intent to stay are variables related to midwives' and nurses' growth in the organization, which provided for further intervention plans by the Saudi ministry of health to assess the workplace environment to enhance midwives' and nurses' empowerment and resilience.

Aim: To evaluate the platelet indices in differentiating reactive and clonal thrombocytosis. Study Design: Observational study Place and Duration of Study: Department of Pathology, Saveetha Medical College, Chennai, and the duration of study is one year. Methods: This is an observational study conducted at our college for a one-year duration. A total of 100 patients with thrombocytosis of platelet count over 4.5 lakhs/mm3 will be included in the study. The study sample consists of cases with thrombocytosis of over 4.5 lakhs. The utility of platelet indices Mean Platelet Volume (MPV) and Platelet Distribution Width (PDW) for the differential diagnosis of thrombocytosis were analysed and assessed. Results: Out of the total 100 cases, 94 were reactive thrombocytosis, and 6 were confirmed to be clonal in origin. Infectious and reactive aetiology was significantly more compared to clonal thrombocytosis. Patients with reactive thrombocytosis showed a lower mean platelet volume and platelet distribution width compared to primary thrombocytosis. In reactive thrombocytosis, MPV ranged from 8.0 - 9.0 fl with mean MPV of 10.6 fl and PDW ranged from 8.4 – 10.1 % with mean PDW of 10.26 %. In clonal thrombocytosis, MPV ranged from 8.2 –1 1.1 fl with mean MPV of 9.5 fl and PDW range was 8.9 – 11.2 % with mean PDW of 10∙1%. Conclusions: The findings of our study favour a reactive cause in thrombocytosis when MPV and PDW are in the lower range and clonal causes had a high MPV and PDW in comparison to reactive causes.

Introduction: The neutrophil-lymphocyte ratio (NLR) is an economically accessible tool useful in cases of Type II Diabetes Mellitus (T2DM). It can be utilized as a laboratory index, indicating systemic inflammation. The sensitivity of NLR to HbA1c must be validated to utilize for its prognostic potential. Correlation of HbA1c with NLR and other parameters have been analyzed to assess the utility of NLR in chronic cases of T2DM, thereby evaluating the utility of NLR as a marker of systemic inflammation in diabetes. Place and Duration of study: Department of Pathology, Saveetha Medical College, Chennai, One year. Objectives: 1. To compare levels of NLR and other parameters in diabetics with those of healthy people and observe the nature of correlation between HbA1c and other parameters.2. To find the linear relationship between HbA1c and other parameters in the diabetic population. Material and methods: An observational study conducted at our Institute from January to October 2020. Blood profiles of 240 T2DM patients and 100 healthy controls were recorded. Results: The NLR (5.35) of T2DM group was significantly elevated (p 0.001) compared to NLR of control group (2.16). Urea and creatinine levels had positive regression coefficients with HbA1c indicating susceptibility of diabetic patients to diabetic nephropathy. Conclusion: NLR showed significance in T2DM. Increased NLR is associated with elevated HbA1c and poor glycemic control in patients with T2DM. It can be used as a prognostic tool during the follow up of diabetic patients.

This study looked into pension assets investments and its impact in the Nigerian economy. The investments includes quarterly reports of corporate debt securities, government bond securities, mutual funds’ investments, money market instruments, private equity funds and real estate securities from 2004 – 2020, and was sourced from the statistics database of the National Pension Commission, the Central Bank of Nigeria and the World data bank. The statistical measures used to analyze the data are the descriptive test, Unit root test, Co-integration test, Vector error correction, Causality and Impulse response function. The outcome of the analysis show that the variables were stationary after first differences were taken; and were also co-integrated at 2 lags indicating that both short and long run equilibrium relationship exist among the variables. From the vector error correction model, previous years’ deviations from long run equilibrium had a 0.09% speed of adjustment; leading to a short run equilibrium. The Causality test reveal that changes in government bond securities lead to changes in real estate securities and changes in money market investments leads to changes in government bond securities. In addition, the impulse response demonstrates that a shock to the system produces more negative responses than positive ones. The study thus recommends that the pension industry should vigorously create more awareness on the importance of employee pension plan; develop more e-channels to help rake in investible funds as well as develop more innovative products to support diversification of pension fund in different assets classes among others.

Background: Orthodontic treatment involves the use of appliances such as braces or aligners to straighten teeth and improve bite. Maintaining good oral hygiene during treatment is crucial to prevent the development of dental caries and periodontal disease. Methods: A literature search was conducted using PubMed, Cochrane Library, and Google Scholar for studies published between 2018 and 2022. The search terms used included "orthodontic treatment," "oral hygiene," "dental caries," and "periodontal disease." Inclusion criteria for studies were: (1) written in English, (2) published in peer-reviewed journals, (3) focused on orthodontic treatment and oral hygiene, and (4) included original research. Exclusion criteria were: (1) case reports, (2) reviews or meta-analyses, (3) not focused on orthodontic treatment or oral hygiene. Results: A total of 28 studies were included in the systematic review. The majority of the studies were observational in nature and conducted on adolescent patients. The studies consistently demonstrated that poor oral hygiene during orthodontic treatment is associated with an increased risk of dental caries and periodontal disease. Specifically, a poor oral hygiene status was found to be associated with a higher incidence of white spot lesions, gingivitis, and periodontitis during treatment with fixed appliances. Conclusion: The results of this systematic review demonstrate the importance of oral hygiene in orthodontic treatment. Patients undergoing orthodontic treatment should be educated about the importance of maintaining good oral hygiene to prevent the development of dental caries and periodontal disease. Dentists and orthodontists should closely monitor the oral hygiene status of their patients during treatment and provide appropriate interventions to improve oral hygiene and prevent the development of oral health complications.

This study was conducted to evaluate the presence and concentration of Oxytetracycline and Penicillin G residues in raw cow and Fermented milk consumed in Maiduguri, Northeastern Nigeria. A total of 172 (86 raw and 86 fermented) milk samples were randomly collected from different milk selling points in Maiduguri. A Spectrophotometer ultraviolet visible spectrum machine was used to detect and quantify the oxytetracycline and penicillin G residues in the milk samples. All samples (raw and fermented milk) tested positive for oxytetracycline and penicillin G residues with a mean residual concentration of 36 µg/L and 20 µg/L in raw and fermented milk respectively for oxytetracycline while the mean residue concentration of penicillin G is 649 µg/L and 397 µg/L in raw and fermented milk respectively. However, the oxytetracycline residues detected were all below the Maximum Residue Level (MRL) standards of 100 µg/L, while the penicillin G residue detected were all above the maximum residue standard of 5 µg/L. The maximum and minimum residue for oxytetracycline detected in raw milk was 79 and 10 (µg/L) respectively while the maximum and minimum residue detected in fermented milk was 42 and 9 (µg/L) respectively. The maximum and minimum residue detected for penicillin G residue in raw milk was 1993 and 767 (µg/L) respectively while the maximum and minimum residue detected in fermented milk was 288 and 164 (µg/L). This study revealed the presence of both oxytetracycline and penicillin G residues in raw and fermented milk consumed in Maiduguri. However, oxytetracycline residues detected in this study were found to be within the acceptable limits, while the penicillin G residues were highly above the MRL standard set by CODEX.

Background: The liver has a vital role in the hemostatic system. It is the site of synthesis of proteins responsible for clotting factors and their inhibitors. Liver infections/ diseases pose the effective functioning of the liver enzymes and clotting profiles. Objective of Study: This retrospective study aims to determine the plasma level of APTT, PT, in patients with chronic disease state in the University of Abuja Teaching Hospital, Gwagwalada, Nigeria. Materials and Methods: A total of 144 participants were enrolled for this study; both PT and APTT were analyzed using Quick and kaolin methods, respectively. Results: 144 candidates who met the inclusion criteria were recruited for this study. table 1.0 and 2.0 showed relationship between PT and APTT in liver infections/ diseases respectively, among the subjects, 81 subjects had Asymptomatic HBV Infection with mean ± SD of 15.3704± 3.0391, 18 Asymptomatic HCV infection, 2 HBV and HCV coinfection, 34 Chronic HBV, 6 Chronic HCV, 1 HCV/HIV coinfection, 1 Chronic HCV /HIV coinfection, 1 HBV/HIV coinfection, and Liver cirrhosis. They was non-statistically significant decrease in the level of PT among patients with both asymptomatic and chronic HBV, HCV, HBV and HCV co-infection, HBV co-infection with HIV, HCV co-infection with HIV and patients with liver cirrhosis with P-value of 0.229. Conclusion: Findings from this study demonstrated that coagulation profile has an association with liver disease.

Background: Intellectual disability is a disability characterized by limitations in the intellectual functioning and resulting in the need for extraordinary supports for the person to participate in activities involved with typical human functioning (Wehmeyer, Schalock, Verdugo et al., 2008). Rehabilitation is therefore an essential aspect in the life of the person with a disability. According to the World Health Organization (WHO, 2011), rehabilitation is a process that is aimed at enabling disabled persons reach and maintain their optimal physical, sensory, intellectual, psychological and social functional levels. Special schools provide the rehabilitation needs by encompassing educational needs, rehabilitation services and integrated education (Kuyini 2014). Special education has proven to be instrumental in the provision of activities that will foster social development and to the maximum extent possible assimilation into regular schools and community activities (Smith 2007). Aim: To investigate the activities undertaken to rehabilitate children with intellectual disabilities in selected schools in the Kumasi metropolis. Methods: The study was undertaken at the Garden City Special School and Community Special Vocational School and employed the use of the descriptive design with a qualitative approach. A sample size of fifteen respondents were used, out of which nine (9) were teachers and six (6) were parents. The study made use of two sampling techniques to select the respondents. The sampling technique employed in the selection of teachers was the non-probable purposive sampling whereas the technique for selecting parents was the convenience sampling. Research data was collected by the use of an interview guide and the data collected was analysed using thematic content analysis. Findings: The study found out that the activities undertaken to rehabilitate the students with intellectual disabilities in the selected schools, had the underlying basis of promoting independent living and improving the social skills of children with intellectual disabilities relationships with people. Teachers therefore ensured that students were trained in the activities of daily living, communication skills, social skills, fine and gross motor skills, functional arithmetic, vocational skills and the concept of money. The study revealed that children with intellectual disabilities gained a substantial increase in their social interactions and their health. However, it was noted that the special schools faced some challenges that hindered their rehabilitation efforts and these included inadequate teaching and learning materials, lack of new facilities and inadequate and unskilled teachers. Conclusion: The special schools are very instrumental in improving the quality of life of persons with intellectual disabilities.

The purpose of this study is to find out and analyze the Weaknesses of Indonesia's Current Land Dispute Regulations and how to Reconstruct Indonesian Land Dispute Regulations Based on Pancasila Justice. This study uses a constructivist paradigm with a sociological juridical approach to solving research problems by examining secondary data and primary data by finding legal realities experienced in the field as well as qualitative descriptive methods. Based on the results of the research, it was found that the Weaknesses of Indonesia's Current Land Dispute Regulations Fundamentally, the land is an asset with high economic value and is very vital for human life, so in this case many parties seek to profit from various transactions related to land. Despite the fact that landowners are legally required to register their rights to their property, it is not uncommon to find a phenomenon nowadays of landowners who do not want to properly register their ownership rights to land. This usually happens due to various factors such as the process which is considered too long and will take up a lot of time and money they have. Reconstruction of Indonesian Land Dispute Regulations Based on Pancasila Justice because in general, justice is a universal value that includes recognition and respect for everyone's legal rights and safeguarding freedom, honor, and property through upholding truth and justice. Then, the balance of rights and obligations is one of the most important characteristics of justice. Furthermore, Justice is also seen as the ability to stand in the middle of two things and give everyone what he deserves. In this case, every living thing in the process is very closely related to the concept of justice in the use and use of land.

This study aims to study the role of balanced scorecard dimensions (financial perspective, student perspective, internal operations perspective, learning and growth perspective, community partnership perspective) in evaluating spending efficiency in public universities in the Kingdom of Saudi Arabia: an applied study on the colleges of Qassim University, which is Raising the efficiency of government spending issued by the Authority for the Efficiency of Spending and Government Projects is one of the goals of the Kingdom's Vision 2030. The study will answer the following question: Does the balanced scorecard apply with its following dimensions (financial perspective, student perspective, internal operations perspective, learning and growth perspective, community partnership perspective) A role in evaluating spending efficiency in Saudi public universities? The study population consists of the colleges of Qassim University, and a sample will be taken from the administrative leaders in the colleges of Qassim University. The data of the current study was collected using the survey method for the study sample by means of a questionnaire, and data analysis using the statistical package for social sciences (SPSS). The current study found that there is a statistically significant relationship (α ≤ 0.05) between (financial perspective, student perspective, internal operations perspective, learning and growth perspective, community partnership perspective) and evaluating spending efficiency in Saudi public universities. The study recommended several recommendations, the most important of which are: the use of the balanced scorecard in public universities in the Kingdom of Saudi Arabia - as a new method for measuring performance evaluation based on its four axes in an integrated manner in addition to the community partnership dimension - that will achieve its strategic objectives in order to enhance its competitive position, work to attract qualified cadres And the ability to design a balanced scorecard and apply it efficiently and effectively in all colleges, which helps it in monitoring and evaluating the financial and operational performance, and Each college should seeks to identify opportunities to raise the spending efficiency , and to establish an independent unit "Spending Efficiency Unit", to adopt best practices and methods, and to prepare reports and measure the efficiency of spending in the colleges.