The Metamorphosis is a novella written by Franz Kafka. This novel tells about a young man named Gregor Samsa who has experienced alienation. This research aims to understand the effects of alienation experienced by Gregor Samsa as a major character in The Metamorphosis. Erich Fromm's theory about three mechanisms of escape is used to analyse the effort of Gregor Samsa in solving his psychological problem of alienation. Modern man usually uses three mechanisms of escape by Erich Fromm to reduce the feeling of fear and isolation of burdened freedom when they want to be free. This research uses qualitative research in which the data are in the form of words and sentences in this novella. This study applies the documentary method as the technique of data collection. The data can be taken from various sources, such as documents, books, and journals. This research shows that Gregor Samsa’s alienation has influenced his entire life, family, and society.

Death and dying is a very interesting topic to study. It has however attracted very little historical, socio- cultural and anthropological interrogations. Among the pristine Bukusu people of Western Kenya, death was accorded numerous socio-cultural rituals that constituted coded meanings which may have only been understood in the realms of religion. This paper thus attempted an examination on how traditional religion was a key determinant in conducting death rituals in the precolonial setup of the Bukusu community that was devoid foreign cultural influence. The findings in this paper were however extracted from a Doctor of Philosophy Degree (History) thesis which will be submitted to Graduate School of Laikipia University by February 2023. The broader objective of the thesis has interrogated mortuary and funerary rituals of the Babukusu of Kenya from 1895 to 2010. Being a historical research, relevant information in the study was collected in the field through extensive Oral Interviews (abbreviated as O.I in the footnotes) which was corroborated with other secondary sources to ascertain the relevance of the information.

Background: Hypertension is a non-communicable disease which is an important risk factor for cardiovascular diseases. The prevalence has been documented to be highest in Africa where 46% of the world’s population with hypertension reportedly resides. There is a global concern that hypertension in teenagers and young adults are on the increase and cases are not detected because of inadequate screening in this age group. Objective: To determine the prevalence of hypertension among undergraduates in Rivers State. Materials and Methods: This was a cross-sectional study conducted in Rivers State. The subjects were recruited from University of Port Harcourt, Rivers State University and Ignatius Ajuru University which are the three major tertiary institutions in Rivers State and their ages ranged between 16 and 35 years. Data collected were analyzed using Statistical Package for Social Sciences. Results: A total of 1096 respondents were recruited for the study, there were 570 (52%) males and 526 (48%) females. Sixteen (1.5%) of them were married while 1080 (98.5%) were single. The prevalence of hypertension among the respondents was 21%. Adding salt to meal before eating and noodles consumption were significantly associated with hypertension. Other risk factors which included smoking, alcohol consumption, and physical inactivity, family history of hypertension and/or CVD and use of social drugs were not significantly associated with increased prevalence of hypertension. Conclusion: The prevalence of hypertension was high in this study there was a significant association between hypertension and risk factors such as salt intake and noodles consumption. Health practitioners should enlighten the public on the presence of hypertension in young people. There is also need to create awareness of hypertension even in young adults and promote early lifestyle changes.

Ovotesticular disorder of sex development (DSD) refers to the co-presence of testicular and ovarian tissue in one individual. Here we report a case of Ovotesticular Disorder of Sex Development in a 42 years old male, presented with abdominal mass and undescended testes who had a normal karyotype. Gonadal dysgenesis should always be kept a possibility in patient with undescended testis. Diagnosis relies on clinical findings, hormonal analysis, gonadal histology, chromosome analysis, and genetic testing.

Introduction: Bacteria that enter the bloodstream and mobile to the brain cord cause bacterial meningitis. The disease is less frequent in developed countries compared to developing countries. In Bangladesh, bacterial meningitis constitutes 25% and the case fatality rate was 14%. The mortality from meningitis is near 100% in untreated individuals and can still be up to 40% in children who received appropriate antibiotic therapy in developing countries. Aim of the Study: The study aims to investigate the specificity, sensitivity, and diagnostic accuracy of CSF-CRP in the diagnosis of Acute Bacterial Meningitis (ABM). Methods: An observational cross-sectional study was carried out in the Department of Pediatric Medicine, Dhaka Shishu Hospital (DSH), from 01 Jan-2017 to 30 Jun-2017. A total of 100 patients were enrolled in this study following the inclusive criteria. Data were collected using the predesigned semi-structured questionnaire. Verbal consent was taken before recruiting the study population. Completed data forms were reviewed, edited, and processed for computer data entry. Result: Among the study population majority of patients (43, 43.0%) were 0-2 years old. One-third of bacterial meningitis (35,35.0%) occurs commonly at an early age (0-2 years). Out of fifty- seven cases (n=57) of bacterial meningitis, twenty-two cases were culture negative and thirty-five cases were culture positive. In the case of bacterial meningitis, in fifty-one cases (51,89.4%) out of fifty-seven, the CSF CRP test was truly positive, with mean±SD 21.7±10.9, false negative were only six cases (6, 10.5%). In aseptic meningitis thirty-nine cases (39,90.6%) out of forty-three cases, the CSF-CRP test was truly negative, and false positive were four cases (4,9.3%). The sensitivity of CSF CRP in differentiating bacterial meningitis from aseptic meningitis was 89.47%, specificity 90.69%, & diagnostic accuracy was 90%. Conclusion: Bacterial meningitis is fatal and more communal in children under one year of age to sixteen years of age. Increased consciousness and initial gratitude and apposite antibiotic treatment can decrease morbidity and mortality. Diagnostic accuracy can be applied as the initial test for the diagnosis of bacterial meningitis.

Background: Fractures of the tibial plateau, which are intra-articular injuries of the knee joint, are often difficult to treat and have a high complication rate, including early-onset osteoarthritis. Various treatment options including proximal tibial plating with locking compression plates are available for the treatment of tibial plateau fracture. Objective: The purpose of this research was to evaluate the functional outcome of tibial plateau fractures treated with locking compression plating; a technique found to effectively reduce post-operative co-morbidities. Material and Methods: This prospective and observational study was carried out in Multicentral base with Department of Orthopedic Surgery, Rajshahi Medical College, Rajshahi, Bangladesh from January 2020 to June 2022. All patients (n=256) enrolled in the study for the study were included and treated with a locking compression plate for tibial plateau fractures (Schatzker III-VI) after receiving informed written permission. Patients were monitored continuously with clinically, radiographically, and functionally at 6-weeks and 3-6 Month, fellow-up after surgery. Results: In our study of 256 cases, the mean age was 37.77 ±15.65 years. Most of the cases were Schatzker type VI (161 patients) 63% and type III (89 patients) 35%. The average duration for fractures union was 23.4 ±2.1 weeks. Superficial wound infection was the common complication seen in (6 patient) 2% cases. At six months, the mean knee society score (KSS) was 85 ±7.22 and majority of patients (245 patients) 95% had good results. Conclusion: The radiological and functional outcome of a locking compression plate is quite excellent. Tibial plateau fractures in adults can be effectively treated with this implant.

Background/Purpose: Diabetes is a metabolic disease characterised by chronic hyperglycaemia, with disturbance of carbohydrate, lipid and protein metabolism, resulting from a defect in insulin secretion and/or action. The International Diabetes Federation (IDF) estimated in 2017 that 425 million people were living with diabetes worldwide. It is estimated that by 2045, 629 million adults will have diabetes. In Cameroon, a prevalence of 5.59% was recorded in 2018, regardless of gender [1]. In the Department of Dja and Lobo, an ethnopharmacological study was set up to identify and characterize the medicinal flower used in the management of metabolic syndrome. Material and methods: Surveys were conducted among 135 people. Data on medicinal recipes used in the management of diabetes, hypertension and obesity were collected according to a standardized framework. The plant samples mentioned were collected and identified at the National Herbarium of Cameroon and characterized. Phytochemical screening was performed on each species. Results: A total of 135 natives from six different villages were interviewed about plants used in the management of metabolic syndrome in the Department of Dja and Lobo. The study identified 85 species in 49 families. The fabaceae, asteraceae and flacourthiaceae families each had at least five species cited by the stakeholders who participated in our investigation. The medicinal plants inventoried totaled 7 biological types. In total 41 species were involved in the treatment of diabetes. The most used preparation methods were decoction and trituration. Phytochemical screening revealed the presence of flavonoids, Phenols, Polyphenols, Tannins, Saponins in almost all the extracts collected. Anthocyanins were extremely abundant in almost all extracts. Conclusion: The results obtained constitute a very valuable source of information for the region studied. The valorization of these plants and the determination of the health profile of the local populations of the Dja and Lobo department requires the establishment of modern processing units specialised in the manufacture of medicines.

Diarrhea is one of the major causes of infant and young children morbidity and mortality globally. It is characterized by passing of more than 3 watery stools within 24hr which is accompanied by loss of body fluids and electrolytes leading dehydration and death if not treated. Therefore, this study was aimed in assessing knowledge and use of Oral Rehydration Therapy (ORT) in the management of childhood diarrhea among mothers. A cross sectional descriptive study was conducted among 103 mothers living in Kambaza metropolis using a questionnaire for quantitative data collection. The data were analyzed using Statistical Package for Social Sciences (SPSS), version 20 and p-value <0.05 was considered statistically significant. The results showed that a significant proportion of respondents were below the age of 36 years (25-35years) with the mean age of 30±0.327 years and most of them (92.2%) were married. 81.6% of the respondents heard knowledge about ORT and majority of them (82.5%) indicated they know to prepare ORS/SSS. The use of ORT in the management of childhood diarrhea was also found to be high (82.5%) among the mothers. A significant portion of the mothers (95.1%) indicated already made ORS sachet was more effective in treating diarrhea than home-made SSS. There is no significant relationship between maternal level education and use of ORT in the management child diarrhea (p=0.476). However, a significant relationship exit between maternal knowledge on ORT preparation and its usage for management of childhood diarrhea (p=0.037). This study recorded high knowledge and use of ORT for management of childhood diarrhea among mothers of under-five children. Therefore, it recommended that maternal knowledge on use of ORT and its preparation should be encourage.

Nanotechnology is widely used for the manufacturing of photovoltaic (PV) solar cells. Applications of solar technology are based in two forms; lithium-ion and lead-acid. These cells and batteries have the capacity to store a large amount of energy longer than other ordinary batteries. The mechanism for manufacturing solar cells usually arises from the combinations of layers of single-molecule thick sheets of graphene and molybdenum diselenide. In this fact, one of common example is the fine coating of graphene with zinc oxide nanowires. Solar based cells are incorporated into the modified forms for increasing their synthetic applications. These modified forms are copper indium selenide sulfide quantum dots. Perovskite solar cells are dominating in the scientific community due to their advantages and cheap sources of solar energy. These perovskite solar cells are also composed of different metals and other combinations in order to make them functional for different purposes. The most widely implemented metals are germanium, antimony, titanium and barium. Tin (Sn)-based perovskites allow the movement of ions and electrons and significantly in the surrounding environment. There is also need in the future for valuable and mechanical designing for nanotechnolgy and their usage in industrial and commercial applications.

Background: Dermatophytosis is a worldwide health-related problem, affecting 20-25% population globally. Once it was very easy to treat with either topical or systemic antifungal agents but now become a challenge for dermatologists because of increasing resistance against conventional antifungals fluconazole, itraconazole, and terbinafine with standard dosages and duration for the last few years in Bangladesh. Search for an effective new oral antifungal agent now become essential. Aim of the Study: To evaluate the efficacy and safety of the new antifungal agent voriconazole in the treatment of refractory and recurrent cases of dermatophytosis. Methods: The study was conducted in the outdoor patient department of Jahurul Islam Medical College Hospital, a rural-based tertiary care teaching hospital on 100 patients with extensive, recurrent, treatment failure cases of dermatophytosis. The clinical diagnosis was confirmed by KOH microscopic examination. Patients were given oral voriconazole at a dose of 200mg twice daily one hour after food for 4 weeks. The patients were followed up at week 2 to assess clinical response and any adverse effects from the prescribed drug. The final efficacy assessment was made at the end of week 4 with the combined evaluation of mycological results and the sum of clinical scores according to a 4-point physician assessment scale of 0-3 (0-absent, 1- mild, 2-moderate, 3- severe). Results: A total of 100 patients completed the clinical trial. Among them 52% were male and 48% were female. The 15-25 year’s age group was 34% and the 26-35 year’s age group was 24%. Majority of patients 56% had a duration between 6 months to <1 year. Of all patients, 100% had tinea corporis and tinea cruris was present in 85%. Involvement with outdoor work was present in 60% of cases. A Complete cure was seen in 82%, mycological cure was seen in 12%, and failure to treatment was seen in 6% cases. Adverse effects were seen in 40% of patients with visual disturbances in 27%, followed by headache and skin rash in 5% and 3% respectively Conclusion: Based on the result, it can be concluded that voriconazole is a highly effective and safe oral antifungal agent that can be used in the treatment of recurrent therapy-resistant cases of dermatophytosis.

Commercial advertisements play a significant role to introduce or define a product, its quality and its uniqueness to a purchaser. The roles of advertisers are thus very crucial in the modern day cut throat competition. The present study has examined how advertisements have depicted women in popular commercials from different points of view. It is found from the study that women have been projected as mothers, sisters and friends as per the situational demand. In case of older women, nurture and care are depicted and it is shown how they play a pivotal role in their families and thereby maintain social balance. In case of middle-aged women, their love and care for their children remain the central point of focus; whereas in the case of young women, their charm and relationships are the point of focus. However, some advertisements focus on erotic side and depict women in such a manner which hurts the culture and balance of the society.

The aim of this study was to discuss the significance of microplate osteosynthesis in pediatric mandibular fractures. Patient and methods: Ten patients with age ranged between 1-10 years were collected from those attending the outpatient clinic of Oral and Maxillofacial Surgery Department, Al- kawait Hospital, Sana’a University. All patients that have mandibular trauma associated with either single or multiple fracture lines in the mandible were included in this study. Diagnosis of the mandibular fracture was achieved through history, clinical and radiographic examinations. All patients were treated by open reduction and internal fixation by 1.2mm microplate. Results: No signs of infection in or around the incision during fracture treatment were observed, and the soft tissue healing progressed normally. Clinical follow up was done every other day for two weeks and after three months postoperatively. Conclusion: Management of mandibular fracture in children by open reduction and microplate is an acceptable method for treatment with least morbidity and increase stability of displaced segment.

Hypodontia is a congenital absence of one or more teeth. It is a common malformation with a variable etiology. Early diagnosis and multidisciplinary intervention is required to reach an optimal outcome. Orthodontic treatment is often required to manage space and facilitate later restorative treatment. This article describes a multidisciplinary treatment approach for congenitally missing maxillary lateral incisor and second premolars involving orthodontics and prosthodontics specialties.

Breast tumour could be benign or malignant in nature, thus early detection is of the essence for good management outcome. Associated morbidity and mortality in relation to breast cancer, in particular, are of great concern. Among the different challenges in the management of breast cancer, cytopenia is commonly reported, while, associated blood transfusion dependence has received little attention. This study, therefore, looked into the features of breast cancer patients particularly with regards to disease staging and average blood transfusion needs. This cross-sectional descriptive study enrolled 46 female patients accessing medical care for breast tumour in Southern Nigeria. Bio-data and information on clinical assessment were obtained from patients’ case files. Blood sample was collected from each enrolled subject for assessment of carcinoembryonic antigen level by immunochromatographic assay method. Breast tumour was observed to be prevalent among women of reproductive age with a peak at the age range of 36-45 years. Majority of the cases (82.6 %) turned out to be malignant, while 17.4% were benign conditions. Advanced stage 4 cases accounted for 47.4% of the studied group. Increasing prevalence of mortality during therapy was recorded alongside advancement in age as well as stage of the cancer. The carcinoembryonic antigen level varied significantly across the various breast cancer stages. Stage 4 breast cancer showed significantly elevated mean value compared to both stages 1 and 2. There is prevailing late detection of breast cancer in the Nigerian population contributing to high mortality rate and more demands on blood transfusion.

Introduction: Wound and mesh infections after inguinal hernia repair are very severe complications. Today it is an established fact to repair hernias with meshes in various ways to prevent or delay the recurrence of hernia, but knowledge regarding the incidence of mesh infection is rare. The aim of the study was to assess the incidence of mesh infection in Open Inguinal Hernia Repair. Methods: This retrospective study was conducted at the Department of Surgery, Sylhet M.A.G Osmani Medical College, Sylhet, Bangladesh during the period from January 2020 to December 2021. The study included 400 patients who underwent mesh repair for inguinal hernia repair during the 2 years period. Among the total 400 patients, 24 were diagnosed with mesh related infections. Mesh related infections influenced by type of mesh use; surgical techniques and underlying comorbidity were all recorded. Both medical and surgical management required for mesh infection were also recorded. Use of antimicrobial included coverage of staphylococcus. Laparoscopic hernia repair cases were excluded from the study. Result: The study found 24 mesh related infection in a total of 400 patients who underwent open inguinal hernia repair. The overall mesh related infection rate was 3%. The infection was established at a variable delay after mesh insertion, with 40% delayed onset after procedure and 60% diagnosed during the first post-operative month. Infection was cured in 6 patients after mesh removal. Conclusion: Mesh removal appears to be one of the appropriate treatments for this rare and serious complication. The most common pathogen was Staphylococcus aureus and E. Coli. The possibility of a mesh related infection remains active weeks or even years after initial hernia repair. If mesh infection develops it should be treated vigorously and mesh should be excised early if necessary.