Introduction: Epidural anesthesia and analgesia have the potential to reduce or eliminate the perioperative physiologic stress responses to surgery and thereby decrease surgical complications and improve outcomes. This study aimed to integrate experimental and clinical data addressing the physiologic effects of epidural anesthesia and postoperative epidural analgesia on surgical patients and to review the real and potential benefits of this technology concerning patient outcomes. Methods: This prospective observational study was conducted at the Department of Anesthesia, Upazilla Health Complex, Daganbhuiya, Feni, Bangladesh. The study was carried out from June 2020 to July 2021. A total of 110 patients were selected as study subjects as per inclusion criteria. Result: Out of 110 study subjects 20 (18.19%) subjects were in the 25-30 years age group, 30 (27.27%) were in the 31-35 years age group and the rest 60 (54.54%) were in >35 years, age group. Regarding the region of surgery done, 50% of subjects underwent lower abdominal surgery, 20% underwent surgery of lower extremities, 15% underwent labor pain, and the rest 15% underwent cardiothoracic surgery. Concerning intraoperative complication, hypotension was predominant which constituted 9% of total study subjects followed by nausea & vomiting seen in 3% of patients. 2.5% of patients had bradycardia, 2% experienced hypertension, only 1% of patients had tachycardia, and none experienced poor anesthesia. In terms of postoperative complications, post-dural puncture headache was predominant which was seen in 4% of patients, 2% had prolonged ICU stay, 2% had cardiopulmonary complications, 1% had postoperative pain, and 1% experienced occlusion of catheter and catheter fragment retention. It was seen that 95.5% of total patients did not need ephedrine or atropine, only 2% of patients needed ephedrine during the operation due to hypotension and 2.5% needed atropine during the operation due to bradycardia. Regarding the advantages of epidural anesthesia, reduced ileus was seen in 105 (95.45%) patients, reduced length of hospital stay in 108 (98.18%) patients, and reduced 30-day morbidity and mortality in 110 (100%) patients. The overall surgical outcome was excellent as well. In 98% of cases, the surgical outcome was satisfactory and only 2% showed poor surgical outcome. Conclusion: The effect of anesthetic and postoperative analgesic techniques on perioperative outcomes varies with the type of operation performed. Overall, epidural analgesia provides better postoperative pain relief and surgical outcomes.

Primary adenoid cystic carcinoma of cervix is a rare entity. Co-existence of adenoid cystic carcinoma with squamous cell carcinoma is even more rare. Here we present the case of an 85 year old postmenopausal lady who presented with on and off vaginal bleeding and was found to have a hard cervical mass. Hysterectomy with bilateral salpingo-oophorectomy was done and histopathological evaluation revealed coexisting solid variant of adenoid cystic carcinoma and squamous cell carcinoma. High grade squamous intraepithelial lesion was seen adjacent to invasive squamous cell carcinoma. Adenoid cystic carcinoma was positive for CD117 and squamous cell carcinoma was positive for p63. Both the components were also immunoreactive for p16.

Background: Acute rotavirus diarrhea is one of the leading cause of morbidity and mortality in children younger than 5 years. Nitazoxanide, an antiparasitic agent, acts by inhibiting the maturation of rotavirus viral protein 7 thus interferes with viral morphogenesis. Aim of the study: was to evaluate the role of nitazoxanide in the treatment of acute rotavirus diarrhea in 6 months to 2 years aged children. Methods: This randomized controlled trial was conducted at Bangladesh Shishu Hospital & Institute, Dhaka, Bangladesh from June 2018 to July 2020. A total of 70 children with acute onset diarrhea of <48 hours. duration was included in this study. All the studied patients were divided into two equal groups (group I and group II) by lottery, each comprising 35 children. The groupI represented the study group who received standard treatment of diarrhea plus oral nitazoxanide (15mg/kg/day) twice daily for 3 days and the group II is the control group received standard treatment only. Results: Study demonstrated that maximum number of patients 22 (31.4%) were between 14-17 months of age group and 36% patients came from rural, 64% from urban areas. Study showed before commencement of treatment most of the patients in both groups experienced some dehydration, vomiting, fever, & abdominal distension. At 48 hours’ improvement was observed in both groups, comparatively higher in group I. Difference of some dehydration and vomiting improvement between two groups were statistically significant (p <0.05). After 3 days’ treatment normal stool consistency was found in 24(68.5%) patients in group I & 10 (28.5%) in group II patients. The difference was also statistically significant (p=<0.05). Mean time of resolution of diarrhea 62.5 hours in Group-I and 96.5 hours in group-II. Compared to the group II, group I showed decrease in mean time of resolution of diarrhea (p= 0.001). The mean duration of hospital stay was prolonged in group-II (86.5 hours vs. 102.5 hours in group I & II respectively), the difference was statistically significant (p˂0.05). Conclusion: In the present study, oral nitazoxanide was found effective in the treatment of acute rotavirus diarrhea in 6 months to 2 years old children.

This research is motivated by the regulations on the construction of houses of worship that have not yet accommodated spaces for justice. Regulations that hinder the construction of places of worship are one aspect that has the potential to cause conflict between adherents of religions. This research aims to analyze and find the principal regulatory requirements for the establishment of houses of worship that are not yet based on the value of justice, to analyze and find weaknesses in the current regulations regarding the requirements for the construction of houses of worship, to find reconstructions for the construction of places of worship that can accommodate these values justice based. This research is normative juridical research with statutory and conceptual approaches. The results of this study indicate that the regulatory requirements for the establishment of houses of worship have not been based on the values of justice (related to the requirements in PBM Article 7 paragraph 1 letter (a) and paragraph 2 letter (a). Article 14 paragraph (2) has not been just Pancasila because they have not been based on community needs. adherents of minority religions Weaknesses in the current regulations regarding the requirements for the construction of houses of worship (Legal substance, legal structure, and legal culture) contained in the regulations for the construction of places of worship Reconstruction of the regulations regarding the requirements for the construction of places of worship based on the value of justice must be referred to whenever justice is discussed So that it is necessary to reconstruct the Joint Ministerial Regulations number 9 and 8 of 2006 concerning the establishment of houses of worship.

Background: General anesthesia is very common anesthetic procedure which is used in several surgical approaches. Without general anesthesia many of these surgeries are lifesaving or life-changing and would not be possible. But all medical procedures are associated with some complications, even when they are performed by experts. The severity and rate of these complications depend on patient’s state of health, age or general lifestyle. Though the general anesthesia using is considered safe, but it comes with certain complications. Aim of the Study: The aim of this study was to assess the complications of general anesthesia in different surgeries. Methods: This was a prospective observational study. The study was conducted in the Department of Aneaesthesia, ICU & Pain Medicine, Shaheed Suharawardy Medical College and Hospital, Dhaka, Bangladesh during the period from January 2019 to December 2019. In total 57 participants in treatment under various department of the mentioned hospital and was prepared for surgery were included as the study subjects. All the demographic as well as clinical data were recorded. As per necessity all data were processed, analyzed and disseminated by using MS Excel and SPSS version 23.0 program. Results: As the complications of general anesthesia among our participants, we found somnolence, ‘dry mouth/increased thirst’ and pain in operated place were found in more than 50% cases separately which were found in 67%, 79% and 82% cases respectively. On the other hand, in 25>50% cases disorder of consciousness (25%), ‘weakness and pain of muscles (28%)’, ‘nausea and vomiting (30%)’, headache (33%) and ‘sore throat/hoarseness (37%)’ were found separately which was noticeable. Besides these, breathing problems, urination problems and feeling cold/chills were observed in some cases. Conclusion: Usually, general anesthesia is a safe way for ensuring patient’s safety and comfort during surgery, but till now it is associated with some complications which have to be recognized and deal with. Contentious development in the procedure of using general anesthesia is necessary to reduce unwanted complication.

Uterine leiomyosarcoma is a rare uterine malignancy that arises from the smooth muscle of uterine wall. Presenting symptoms may be vague and mimic other benign uterine conditions. They are notoriously aggressive with poor prognosis. We report a case of a 35-year-old female, who presented with abdominal distension with pain and vomiting. A non-tender mass measuring 14X12 cms was felt on palpation in the same region. CT scan revealed a large, relatively well defined, hypodense pelvic mass in retro-uterine pouch. Patient underwent exploratory laparotomy with primary resection of tumour with pan-hysterectomy with pelvic lymph node resection. Histopathologically, it was diagnosed as pleomorphic sarcoma probably leiomyosarcoma of uterus which showed immunostain Smooth Muscle Antigen (SMA) positive and Epithelial Membrane Antigen (EMA) negative. It was Estrogen Receptor(ER) negative. The rarity as well as pathological diversity makes this study beneficial and this definitive reporting will be helpful in diagnosis of smooth muscle tumours with challenging histologic features.

The dentigerous cyst is reported to be one of the most common odontogenic cyst, of developmental origin, which is characterized by its association with an impacted tooth. Often assymptomatic, the dentigerous cyst presents as a well-limited unilocular radiolucent image surrounding the crown of an unerupted or impacted tooth. Decompression is a conservative treatment option for dentigerous cysts, used especially in children, to preserve the cyst associated tooth, promote its eruption and to avoid lesions of the mandibular canal. This report presents a mandibular dentigerous cyst associated with the 35 impacted tooth in a 12-year-old girl. The dentigerous cyst was successfully treated by surgical decompression.

This study examines the relationships between Foreign direct investment (FDI), Gross domestic product (GDP), Trade, Inflation, Labor force, Population density, Combustible renewables and waste consumption for the case of Central Asia, spanning the period 1990 to 2020. The combustible renewables and wastes consumption in Central Asia are based on the long run and short run relationship between economic development with the Error Correction Model (ECM) based Panel Cointegration tests and Panel Vector Error Correction Model (VECM) Granger causality test tried to explain using the causality test, spanning the period 1990 to 2020. An empirical analysis uses the Im, Pesaran, and Shin (CIPS) Panel Unit Root test and Westerlund ECM to test the basics of the data unit based on this information. The Panel Vector Autoregression (PVAR) specification was based on the results of the Lag-order selection criteria, and the stability of the PVAR model was checked through the observation of the Hausman test and Eigenvalue stability condition. It performs tests to verify the existence of the long run relationships among the variables and examines short and long run causal relationships. It finds that increased combustible renewables and waste consumption use is the main cause of increased economic growth.

A relatively rare congenital malformation, hematocolpos is the progressive accumulation of menstrual blood in the vaginal cavity at puberty. It is often the consequence of a hymen imperforation. It is clinically manifested by cyclic pelvic pain and primary amenorrhea and, more rarely, by a pelvic mass syndrome. The diagnosis is primarily clinical. Ultrasound and magnetic resonance imaging (MRI) are additional tests to confirm hematolcolpos and exclude other associated genitourinary malformations. Treatment consists of a hymenotomy to drain the hematocolpos. The age of discovery of hematocolpos varies from 13 to 14 years. We report a case of hematocolpos secondary to hymenal imperforation diagnosed in a 17-year-old girl with periodic pelvic pain, primary amenorrhea and a pelvic mass. A first ultrasound trap had evoked a large ovarian cyst but the repeat pelvic ultrasound in our hospital confirmed the diagnosis of hematocolpos.

Vocabulary has been playing an important role in language learning. However, to most students in China, vocabulary is the main problem they have met when they learn English. In order to improve their vocabulary learning skills, a study is needed to find out definitions and classifications of English learning strategies used by college students in Changzhi University. Further more, students’ different employment of language learning strategies and the related results are essential to be explored. This thesis aims to investigate the vocabulary learning strategies used by non-English majors by means of questionnaires. The subjects are 238 non-English majors from Changzhi University. Both similarities and differences of application of language learning strategies are explored. The correlation between vocabulary learning strategies and test scores is conducted as well. Further more, some suggestions for lexical learning will be put forward.

Introduction: Low concentration of free testosterone and low serum testosterone levels are associated in males patients with metabolic syndrome and cardiovascular disease and in some cases in connection with critic iliac stenosis and also in most cases with lack of physical activity. Exercise can be also important factor to improve primary bypass and endovascular potency and general health benefits after surigal and endovascular treatment in patients with critical ishemia over 75% of lumen obstruction of short liiac artery segment have positive impact on improvemt of generely Testosterone Levels. Subjects and Methods: 72 selected Patients with Cardiovascular Disease with Metabolic Syndrome and Critic Iliac Artery Stenosis (TASC II A and B) were observed in period 3 years between ferbruary 2015 and ferbruary 2018. In focus was 1 year potency after invasive and minimalinvasive tertmant (45 patients treated with surgical dacron reconstruction and 25 patients with endovascular tretmant of short segment critical iliac artery stenosis (TASC II A and B). Results: In the total population no difference in changes of CIMT from baseline was observed between the standard exercise group and controls. However, there was no significant interaction between the effect of exercise training and primary bypass potency during 1 year. Conclusion: Primary potency of Endovascular procedure and Dacron bypass revascularization after 1 year in exercise training group significantly rise of testosterone levels higher but still not therapy adequate. With potential optimization testosterone therapy levels we can answer of the question. Is any major influence on primary bypass potency and are higher levels of free testosterone are preventing further progressing of cardiovascular disease and generel symptomatic and asymptomatic atherosclerosis?

Intraoperative pathology consultation is often required for guiding immediate surgical decisions so as to limit the extent of surgery. Accurate intraoperative diagnosis is crucial. The present study evaluates the accuracy of imprint cytology and frozen section in intraoperative consultation for tumor and tumor margins. A total of 157 tissue specimens for type of lesion, tumor margins and lymphnode metastasis were included. Imprint was taken by holding the tissue bit with forceps and touching it onto a clean glass slide without undue pressure or lateral movements. They were stained with Papanicolaou, May-Grunwald Giemsa and Hematoxylin and Eosin [H&E] stains. The tissue bits taken were then embedded and frozen. Section cutting was done using cryostat and were stained using rapid Haematoxylin and Eosin stain, and examined under a light microscope. Later, the tissue was fixed in 10% neutral buffered formalin for routine histopathological processing then stained with H&E stain. Based on the histological diagnosis, the accuracy of intraoperative imprint cytology and frozen section were evaluated. A total of 157 tissue specimens were received during the study period, which were classified into specimens for type of tumor [145 specimens], tumor margins [54 specimens] and lymph node metastasis [7 specimens] for analysis. The overall diagnostic accuracy of imprint cytology in detection of type of tumor was 97.9% and that of frozen section was 98.6%. It can be concluded that imprint cytology typically provides the accurate diagnosis without the need for a sophisticated machine such as cryostat which is required for frozen section analysis.

Background: Cervical incompetence (CI) is a common cause of mid-trimester pregnancy loss. Clinical evidence has demonstrated the role of cervical cerclage in reducing preterm births alongside engendering successful maternal and foetal outcomes in carefully selected women with cervical incompetence. This study aimed at determining foetal and maternal outcomes in women with cervical incompetence after elective cervical cerclage. Methods: A retrospective analysis of 88 patients who had elective cervical cerclage at the University College Hospital, Ibadan (UCH), Ibadan, Nigeria between January 2015 to December 2017. Data from the case records of these patients were analysed using the Statistical Package for Social Sciences version 22. Descriptive analysis was generated and summarized with the aid of pie chart, bar chart and frequency tables. Chi-square statistic was used in testing for associations between categorical variables. Results: The mean age was 32.5 ± 4.2 years. Most of the women (78%) had cervical cerclage performed between 14 -16 weeks’ gestation. The most observed complication was pre-term contractions (76.2%). Eighteen women (20.5%) had a miscarriage and 50 women (56.8%) had term deliveries. The mean gestational age (GA) at delivery was 34.1 ± 5.8 weeks. Maternal complications, use of tocolytics and duration of hospital stay had a significant influence on the gestational age at delivery (p<0.005). Conclusion: Cervical cerclage is an effective surgical procedure for preventing and delaying preterm births in women with cervical incompetence evidenced by a successful outcome in 56.8% of cases depicted in this study. Its use in a low-income country with high rates of preventable pregnancy wastages cannot be over-emphasized.

This paper explored the sociocultural, tradimedical, and religious relevance of henna in the Hausa land. The scope is limited to the old Sokoto province, now comprising three states. The research employed a survey method to obtain data from two strata sampled populations through one-to-one interviews. The research has found henna to be a shrub of enormous value and great relevance in the Hausa culture. That includes its relevance and values in different domains of life, including health, religion, as well as socio-economic dealings. However, despite the numerous uses of the henna plant in Hausa culture, it is observed that henna plant cultivation has greatly reduced. Its usage is almost substituted with modern artificial products. It is gradually getting extinct as its cultivation has greatly reduced in most areas of the region (Sokoto province). The paper finally suggested among others that the government and other relevant parastatals should see to the reviving and modernizing the traditional practices, including by supporting the local farmers, conducting clinical research on the product, as well as technologically processing it.

In education, action research is significant. In order to address problems and concerns in the classroom, it enables teachers to figure out what went wrong and what may be done. A way to improve classroom instruction and have a bigger impact on students' overall development in public schools is to train teachers to do action research. This study examined how educational research is viewed in the context of public schools in order to assist teachers in upgrading and improving their skills. Using data from public secondary school teachers in the Division of Agusan del Sur, this study analyzes their motivation for writing, research skills and competence, and perceptions. This research project utilized quantitative research. Specifically, it employed a descriptive-correlational research design to evaluate secondary teachers' writing motivation, research skills, and competence, and perspectives on the parts, scope, and significance of action research. The sample size of the population was determined using Slovin's formula with a 0.05% margin of error. The study had been analyzed using IBM SPSS (Statistical Package for the Social Sciences). The data gathered was treated using standard deviation and mean as statistical tools to interpret the teachers' responses. For a correlational analysis between research-writing competence and motivation in teachers' perceptions, the researcher used an alpha of 0.05 and a confidence level of 95%. The secondary teachers who took part in the study exhibited strong, significant motivation and competence in academic research writing. They place a lot of importance on improving their writing. Secondary teachers are capable of writing action research papers that consider the technical aspects, write an introduction, choose an appropriate methodology, present results, and discussions, come to conclusions, offer recommendations, summarize references, and take other research papers into consideration. The Department of Education should use extensive seminars and workshops on action research to give teachers more knowledge and a deeper understanding of how to conduct research.