Pulmonary Tuberculosis is caused by bacilli mycobacterium tuberculosis and known to infect human race since the dawn of history and archaeological evidence has traced its association in neolithic times. Tuberculosis is the most common infectious lung diseases in India with significant mortality and morbidity. Tuberculosis can cause diverse thoracic presentations ranging from nodules, consolidations & cavitation, mediastinal adenopathy, pleural effusion to diffuse endobronchial disease presenting like bronchial asthma. Due to diverse presentations, diagnosis is many times delayed due to lack of suspicion by treating general physicians and rational treatment many not offered in time. In spite of awareness by government organizations and considered as ‘global health issue of concern’ by World Health organization, tuberculosis is still considered as social stigma. Destroyed lung is described in literature and known complication of pulmonary tuberculosis. Destroyed lung is defined as combination of pleural and parenchymal lung destruction with cavitation, bronchiectasis, loss of lung volume and mediastinal herniation to diseased side. In this case series, we have reported two cases with history of pulmonary tuberculosis in past and received adequate anti-tuberculosis treatment. Both were having residual chronic lung disease and symptoms causing significant impact on quality of life with recurrent hospitalization, hospital visits and cost of care. One patient has history of delayed diagnosis and ATT was started after maximum lung destruction due to tuberculous process has already occurred. In this patient tuberculosis was cured but residual lung damage or sequel presenting as destroyed lung. In second case, tuberculosis was diagnosed in adequate time but patient has defaulted due to adverse events of ATT and he has taken medications as per his own tolerance. Neither adherence nor compliance was acceptable in second case and resulted into partially treated case of pulmonary tuberculosis. Ongoing lung destruction inn second case would be cause for destroyed lung in absence of irrational medicines in today’s era of good quality ATT. Destroyed lung is preventable with early diagnosis, prompt evaluation with microscopy and nucleic acid amplification tests and treatment with universally available, acceptable and affordable free ATT as National guidelines. Destroyed lung is having significant impact on quality of life and health expenditure and considered as ‘radiological stigma’ of Tuberculosis.

Background: Effective root canal treatment involves cleaning and shaping root canals using a range of instrumentation procedures and techniques. The aim of this review was to provide an update on root canal hand instrumentation techniques and how to overcome iatrogenic errors. Purpose: Purpose of this review was to provide an update on root canal hand instrumentation techniques commonly used in endodontics, including how to overcome iatrogenic errors and optimize the quality of endodontic treatment outcomes. Methods: A comprehensive search was carried out using multiple databases, PubMed, Medline, Google scholar, and Scopus, to identify relevant studies addressing the objective of this study and to summarize the current evidence to readers. Results: The hybrid technique is a commonly used approach that combines the benefits of both the crown-down and step-back techniques and was reported to be one of the best techniques to produce an optimal root canal preparation outcome. Hand-instrument manipulation using the balanced forced technique is also favored as it rapidly and safely permits removal of canal contents allowing irritants and medications to reach deep inside canal spaces. Conclusion: The use of hand files is still recommended for initial canal negotiation and preparation and is essential for the correction of procedural errors. This study provided an update on several hand instrumentation techniques commonly used in endodontics. The correct and safe application of these techniques can prevent iatrogenic procedural errors from occurring which optimizes the quality of treatment outcome.

In the present research, the level of cancer antigen 125 (CA125) significantly increased in DMBA experimental groups (group II) compared to normal control group. However the level of CA125 decreased in dose dependent manner with 10% carbohydrate ketogenic diet having the most significant effect. Also, the 7,12-Dimethylbenz(α) anthracene (DMBA) caused significant increase in liver enzymes (Alanine amino transferase, Aspartate amino transferase and Bilirubin) of 41±1.06, 40±1.16, 20.80 ±1.47 and 25±1.34, 27±143, 12.17±1.08 compared to normal control at P<0.05 respectively. Furthermore, with the group treatment 10%, 20% and 30% carbohydrate ketogenic diets also elevated the liver enzymes. More so, a significant decrease was observed in total protein, albumin, RBC, Hb, PCV, MCH superoxide dismutase, glutathione reductase and glutathione peroxidase with a corresponding increase in white blood cells. Interestingly, ketogenic diets significantly increase total protein, albumin, superoxide dismutase, glutathione reductase, and glutathione peroxidase with a decrease in white blood cells, total cholesterol, triglyceride, low density lipoprotein bilirubin concentration. It can therefore be concluded that, the administration of ketogenic diets slows the progression of breast cancer through inhibiting the downstream of insulin receptors of both mammalian target of rapamycin signal cascade and motogen activator protein kinase pathways.

Monthly All Share Index data from 1985M01-2021M12 was sourced from the Central Bank of Nigeria and the Central Securities Clearing System of the Nigerian Stock Exchange; to analyze multiple bubble periods. The supremum Augmented Dickey Fuller (SADF) and Generalized supremum Augmented Dickey Fuller (GSADF) quantitative model with 1000 repetitions along with a window size of 42 was selected to carry out the Monte Carlo simulation at the 95% confidence level. From the Backward SADF estimation, three periods of explosive pricing and collapses were detected. The study therefore recommends that market regulators should promote market information and support regular training of market participants to stem speculations and reduce arbitrage. Overall, well-informed risk management practices should be established to guard against market losses.

Medication mistakes continue to be one of the most serious issues in hospitals. Such mistakes can occur during the prescription, distribution, or administration of medications. Lipid emulsions are commonly utilized in whole or partial parenteral feeding initially, Following convincing results from animal models and effective case reports in humans, the use of intravenous lipid emulsions (ILEs) as an antidote in local anesthetic systemic toxicity has acquired considerable acceptance. Although intravenous lipid emulsion (ILE) was initially employed to treat life-threatening local anesthetic (LA) toxicity, its application has broadened to cover non-LA poisoning and less severe symptoms of toxicity. However, in recent years, the function of lipid emulsions in the treatment of lipophilic chemical toxicity and overdose has been established. In addition to typical poisoning treatment, lipid emulsion therapy was employed. The observed sequence of events provides substantial support for the importance of ILE treatment in the effective management of both instances. However, further study is needed in this area to provide definite guidelines for the use of intravenous lipid emulsions in pediatric lipophilic agent poisoning. The body of data supporting the use of ILEs in acute drug intoxication is growing. The current data supports the use of ILEs only when there is an imminent threat to life from local anesthetic systemic toxicity or lipophilic cardio-toxin poisoning. Lipid emulsion therapy is a potential and less expensive alternative in cases of acute lipophilic poisoning where a specific antidote is unavailable.

This study aims to analyze the access of small and medium enterprises (SMEs) to finance and on the performance in Indonesia. This study used the Enterprise Surveys World Bank (ESWB) panel data from 2009 and 2015. The results of the analysis show that small companies tend to be lower inaccessibility compared to medium-sized businesses. Companies that do not have financial constraints and also participate in financial markets perform better than other companies. Either by using value-added performance indicators or labor absorption the results shows the same direction.

Introduction: EA is characterized by agitation, inconsolable sobbing, disorientation, delusions, and hallucinations, decreased cognition and memory. Sevoflurane is widely used as an anesthetic agent for children because of its less pungent nature, lower solubility but it has a greater incidence of EA in preschool aged children. Propofol is a hypnotic amnestic agent with a short duration of action, commonly used for sedation, induction, and maintaining anesthesia and it has been used to prevent Emergence agitation. Aim of the Study: The aim of this study was to determine the efficacy of low dose propofol in reducing the incidence of EA at the end of face-mask sedation with sevoflurane. Methods: This was a prospective observational study and was conducted in the Department of Pediatric Anesthesia of Bangladesh Shishu Hospital and Institute, Dhaka, Bangladesh during the period from July, 2021 to December, 2021.In our study we took 220 children operated for hernia were randomized into two groups – Group A (Control group, n=110) and Group B (Propofol group, n= 110). Result: In total 220 patients from both the groups completed the study. In our study we found the mean age in group A & B was 6.3 ± 1.6 & 6.1 ± 1.9 years respectively. The mean PAED score was 14.41 ± 2.59 & 9.83 ± 3.51, the mean emergence time was 7.1 ± 2.0 & 13.4 ± 2.5, time in PACU was 44.5 ± 5.9 & 46.6 ± 7.6 mins in control & propofol group respectively. In contrast to the control group, no patient in the propofol group experienced EA beyond 15 or 20 minutes of emergence. Conclusion: In our study, we found that 0.5mg,/kg propofol was effective in preventing Emergence Agitation in children underwent herniotomy with caudal block and who’s sedation were maintained with sevoflurane.

On-the-job training (OJT) program is one of the most crucial programs in higher education and is an integral part of the educational system in the Philippines, specifically in tertiary. The study determined the relationship between the academic performance and practicum performance of 59 BSBA Marketing Management students at the College of Business, Systems Plus College Foundation, who had taken their practicum in 23 organizations. The research method used in this study was the descriptive-correlation method. Data was based on the Practicum Evaluation Report where student trainees were evaluated on 5 performance key area of assessment. It includes personal characteristics, attitude towards the job, job performance, adherence to company policy, and competence breakdown into 22 items. Findings showed that the student trainees got the highest rating on adherence to company policies rated as very good, followed by job performance, attitude towards, competence, and personal characteristics. The students were rated low in oral and written communication skills as an area for evaluation with a rating of good. Thereby creating an impression that this area should be improved by strengthening the communication skills in all courses by integrating interactive teaching-learning methods like presentations, role plays, debates, cases, written reports, portfolios, and reaction/ term papers to further their communication skills.

Background: Spinal dysraphism refers to a group of developmental abnormalities that affect the spinal cord and its surrounding structures. The main goals of treatment of spinal dysraphism are to prevent further damage to the spinal cord and to improve the patient's neurological function and quality of life.Aim of the Study: The aim of this study was to assess the management of spinal dysraphism .Methods: This cross-sectional study was conducted in Department of Pediatric Neuro Surgery, Bangladesh Shishu Hospital and Institute, Sher E Bangla Nagar, Dhaka 1207, Bangladesh, during the period from 1st April 2020 to 31st March 2021. Total 1052 patients were admitted under Neurosurgery department (SU IV) from them 93 patients had spinal dysraphism. After excluding patients with encephalocele, lipomeningocele, meningocele and DORB, total 60 patients with myelomeningocele were included in this study.Result: Majority of the subjects (71%) were less than a week old. there was a slight female preponderance (54%) among the study subjects. The most affected (83.33%) region of the spine among the study subjects was lumbosacral. The data showed that 65% of the study subjects had no lower limb movement, while 35% of them had slight movement. In the study, all study subjects had abnormal bowel and bladder habits. In the study, the majority (62%) had a moderate ventricular index level before operation. About 83.33% of the study subjects had a satisfactory outcome after the surgery, while 6.66% had poor outcomes, and 1.66% of the study subjects died after the surgery. The data showed that 80% of the study subjects had a severe Ventricular Index after two weeks of surgery, while 20% had a moderate Ventricular Index. The data also indicated that 85% of the study subjects had a healthy wound after surgery, while 15% had an unhealthy wound.Conclusion:From the findings of our study, it can be concluded that for improving the quality of life of the patients with spinal dysraphism, surgery is the prominent treatment accompanied by optimal post-operative care. Surgery of spinal dysraphism is associated with higher satisfactory rate and lower post-operative complications.

The goal of this study is to see if there is a link between online selling via social media and impulse purchases. The steps in the methodology are as follows: Quantitative research, particularly descriptive research, is used to design research that tries to characterize the existing state of variables. With a total of 387 Young Professional respondents from Angeles City, Pampanga, the researchers also gave self-made questionnaires and utilized a Likert scale as the foundation for responding to the survey. To correlate the link between social commerce and impulsive purchase decisions, the facts were studied using statistical analysis using mean rating and Pearson r correlation. It was discovered that the Young Professional's impulse purchase choice and social commerce (hedonic and social) had a substantial association. The researchers suggested that social commerce be more trustworthy to earn trust and credibility, that sales promotions be established to enhance customer retention, and that outstanding customer service is provided to offer customers a more pleasant experience and add value. The findings point to the necessity for more investigation into other elements that influence social commerce.

Financial liberalization is a process that could be profitable for growth but it may pose serious problems to the development and economic prosperity. The objective of this paper thesis is to evaluate by using panel data, the effect of financial liberalization and institutional quality on banking development on a sample of 17 Arab countries over the period 1990-2012. The empirical findings suggest that financial liberalization could have a positive effect as well as the institutional quality on banking development for the Arab region.

Background: Pierson syndrome comprises of congenital nephrotic syndrome (CNS) and peculiar ocular changes. LAMB2 gene mutation has been reported to be causative reason for this rare autosomal recessive disorder. Methods: An observational case series reports comprising of two children presenting with symptoms like heavy proteinuria, haematuria are being discussed. Physical examination along with ophthalmological assessment, hearing assessment, varied blood investigations, urinalysis, renal biopsy and gene testing were carried out to diagnose the condition. Results: Pearson syndrome was detected with mutations of LAMB2 gene detected by Whole Exom Sequencing test in one of the case study. The Ocular abnormality in both patients comprised of squint hypertropia, a new variant ocular finding related to Pearson syndrome. Conclusions: The clinical finding of squint hypertropia is a novel finding associated with Pearson syndrome, reported here for the first time.

Discipline is an attitude and deed or behavior that can be supported by students in the form of students’ habit in performing and obeying regulations in an orderly manner in accordance with the existing rules. In addition, discipline is defined as a character that needs to be trained for all students, including teenage students who are in high school. The discipline quite often becomes the responsibility of all schools, both guidance and counseling teachers, assisted by subject teachers, class teachers, staffs and school principals. This study aims to determine the constraint and strategy of Guidance and Counseling teacher in increasing students' discipline in Sleman High School. This study is a qualitative research, a type of phenomenology, data collected by observation, interviews and questionnaires. Participants in this study were 15 guidance and counceling teachers, from high school level in Sleman Regency, Yogyakarta, Indonesia. Data analysis used is quantitative descriptive technique. The data was analyzed by Milles & Huberman with data reduction, data presentation, verification of the conclusion. The result of this paper showed that the strategy of Guidance and Counseling teacher had a positive impact in enhancing the students' disciplinary behavior as well as being able to shape the character of students to be better human being.

The purpose of this study is to describe the social and moral values in the novel Bumi Manusia by Premoedya Ananta Toer. This research uses qualitative methods, namely research that pays attention to natural data, data in relation to the context of its existence. It is these ways that encourage qualitative to be considered as multi-method because research in turn involves a large number of relevant social phenomena, the object of research being a novel written by Pramoedya Ananta Toer entitled "Bumi Human". The most commonly found element in social values is the social value in the value of affection. This value is found a lot because there are values of devotion, caring, kinship, helping. The results of this study found that social value is something that is considered good or bad in community groups. To determine whether good or bad must go through a weighing process by analyzing what is observed in community groups. In social values, there is a value of compassion related to the affection bestowed by the creator to humans so that a value of compassion has been instilled in humans since they were born, the value of responsibility relates to an act carried out by each individual based on obligation or calling. a person, and the value of harmony in life is related to tolerance, cooperation, justice, and humanity. This of course can provide the value of knowledge that is not yet known by the public.

The purpose of this study is to assess the impact of the online practicum program on students' professional development, personal growth, skills, and abilities at the College of Business, Systems Plus College Foundation in Angeles City, Philippines during the pandemic. The study included 28 practicum students from the College of Business of Systems Plus College Foundation, Angeles City, Philippines, who were studying Bachelor of Science in Accountancy and Bachelor of Science in Customs Administration. The research employed a structured questionnaire of 28 closed-ended items rated on a 5-point Likert scale on gender, course pursuing, reason and expectation from the practicum, and influence of practicum on the professional development, personal growth, skill, and abilities of the respondents. The gender, course pursuing, reasons, and expectations of respondents were analyzed using descriptive analysis. A reliability scale through Cronbach Alpha was used to assess the questionnaire's reliability. normality was evaluated employing univariate and multivariate normality of skewness and kurtosis, and a non-parametric test through Mann-Whitney test was used to calculate the p-value measuring the evidence against the null hypothesis. The evaluation on the influence of online practicum among the respondents was carried out through a non-parametric test using Mann Whitney test. The study's findings show the influence of internship programs on the professional and personal growth and skills of COB-SPCF business students.