Background: Low back pain and sciatica are two of the most common health disorders that people experience. Both the number of hours that employees put in and the amount of money that is lost by the nation as a whole see significant reductions as a result of these changes. Before beginning any kind of treatment with these individuals, it is very necessary to do a thorough physical assessment on them. It is possible for symptoms to worsen as a result of receiving insufficient medical or surgical treatment, which increases the likelihood of this happening. The purpose of this study is to evaluate the effectiveness of acupuncture in conjunction with PLID treatment. Methods: This inquiry took place at SUOXI Healthcare Limited in Shantinagar, Dhaka, Bangladesh. A 36-year-old male patient has been complaining of lower back discomfort, tingling and numbness of right leg for the last two years. The diagnosis was confirmed with a MRI of lumber spine. Results: Follow-up research showed promising outcomes. He no longer felt discomfort in his lower back and tingling and numbness of right leg, which he had been experiencing for two years. PLID patients may benefit from acupuncture, according to the findings of this study.

This research aims to provide empirical evidence on the influence of institutional ownership, leverage, and liquidity on tax avoidance with company size as a moderating variable. The sampling method used was simple random sampling, resulting in 132 sample data. The data analysis techniques used were multiple linear regression analysis and Moderated Regression Analysis (MRA). The results of this study indicate that institutional ownership, leverage, and liquidity do not have a significant impact on tax avoidance. Company size as a moderating variable strengthens the relationship between institutional ownership and leverage with tax avoidance. Meanwhile, the company size variable as a moderating variable weakens the relationship between liquidity and tax avoidance. This research considers the effectiveness of company size involvement as a moderating factor in the influence of institutional ownership, leverage, and liquidity on tax avoidance in property and real estate companies.

Introduction: Neonatal septicemia is one of the most common causes of infection and mortality in neonates, due to which 30–50% of neonates die each year in developing nations. Various studies have suggested that bacteremia occurs in 20% of neonates, and approximately 1% die due to neonatal sepsis. It affects newborns below 1 month of age and encompasses systemic infections including meningitis, pneumonia, arthritis, osteomyelitis and urinary tract infections. Objective: To assess the Bacteriological profile of neonatal septicaemia and antibiotic susceptibility pattern of the isolates admitted in SCANU of a tertiary levels hospital of North Bengal, Bangladesh. Methods: A prospective study was conducted including 50 suspected cases of septicemia admitted to the Special Care Neonatal Unit (SCANU) of the selected Department of Paediatrics, TMSS Medical College, Bogura Bangladesh July to December 2022. Demographic data included birth weight, gestational age, postnatal age, and treatment as well as survival outcome. Clinical and laboratory data included the number of days between birth and admission to the SCANU, admitting and discharge diagnoses, and pharmacological treatment. Data was analysed by percentages of each antibiotic used. And which organism was responsible for neonatal sepsis. Results: Total 50 cases clinically suspected neonatal sepsis were included in the study. The mean age was 8.33±7.36 days, mean birth weight was 2816.25±288.6gm, male were predominant which was 70%. Among gestational age of the Neonates having septicemia Preterm (<37) 66% and Term (37 up to 42) 36%. Out of the 50 proven sepsis cases, 36 cases (72%) were early onset and 14 cases (28%) were late onset. In this study out of 50 cases 16 cases were culture positive septicemia which was 32%. Gram negative organism were predominant with 10 isolates (62.5%) in comparison to gram-positive 6 (37.5%) isolates was the most common S. aureus (25.0%) and E. coli (12.5%) among the organism isolated. Other organisms isolated were Staphylococcus Pneumoniae (6.3%), Staphylococcus epidermidis (18.7%), Proteus (18.7%), Listeria species (6.3%), Pseudomonas (6.3%), and Enterococci (6.3%). In this study, Staphylococcus aureus was the commonest organism isolated from both EOS (20%) and LOS (33.3%) followed by Staphylococcus epidermidis (10% & 33.3%). Amoxiclave is highly sensitive to S. aureus & E. coli. In this study, vancomycin showed 25.0% sensitivity to S. aureus but for Nitrofurantoin it was only 33.3%. The Listeria species isolates here were 100% sensitive to meropenum. In our study, ciprofloxacin showed 33.3% to 100% sensitivity to different isolates. Conclusion: In the present study, high bacterial resistance among the pathogens suspected to cause neonatal septicemia is demonstrated which can be controlled by prudent use of available antibiotics. This study suggests regular monitoring of the antimicrobial sensitivity of the causative organisms in a particular setting is very important.

The New ligand 5-methyl-2-(2-thienyl)-1,3-oxazole-4-carbaldehyde thiosemicarbazone (HL)(1) was synthesized. This ligand reacted with Co(II) and Ni(II) chloride in ratio 1:2 metal:ligand afforded two complexes, [Co(LH)]Cl2 (2) and [Ni(HL)2]Cl2 (3). The ligand and its metal (II) complexes have been characterized by spectroscopic techniques. The X-ray structural studies revealed that the free ligand exist in thione form and remain as neutral tridentate with NNS donor atoms in the tow complexes beside presence of uncoordinated chloride ions in the cavities of the crystal lattice of the complexes. One of these chlorides in complex (2) is hydrogen bonded to a proton of the amine of the ligand. While in complex (3) the chloride bonded to proton of imine (-N2H) of the ligand and the coordination environment has a distorted octahedral. The oxazole N and S atoms in the two complexes are cis to each other whereas the azomethine N atoms are trans coordinated. The ligand and its metal complexes were tested for their in vitro biological activity against six standard microorganisms: two Gram positive namely Bacillus subtilis and Micrococcus luteus, and one Gram negative bacteria Escherichia coli and three fungi: Saccharomyces cerevisiae (Baker’s yeast), Mucor spec., and Aspergillus niger, at a concentration 100µg/ml.

Indonesia implements a self-assessment system so that taxpayers are trusted to calculate, pay, and report their own taxes in accordance with applicable tax provisions. Companies as taxpayers do tax avoidance by taking the advantage of loopholes in tax regulations without violating applicable regulations in order to pay taxes in the minimum amount. Therefore, this research is conducted to test the effect of profitability, leverage, and financial distress on tax avoidance with independent commissioners as a moderating variable. The population used in this research is all manufacturing companies which are listed in Indonesia Stock Exchange period 2019-2021. The 243 samples are taken by purposive sampling after outliers. The data used are secondary where annual reports and financial statements are obtained from the company’s official websites. This research uses SPSS and the analytical techniques are multiple linear regression and moderated regression analysis. The results of this research prove that profitability has a negative significant effect on tax avoidance, leverage has a positive significant effect on tax avoidance, financial distress does not have a significant effect on tax avoidance, and independent commissioners is unable to moderate the effects of profitability, leverage, and financial distress on tax avoidance.

Tourism plays a significant role in the development of a city, thus, tourism translation through websites plays an irreplaceable role in promoting local cultural publicity. This paper aims to study ways to promote the dissemination of local culture through three parts: literature review, Analysis of website construction and translations of Ancient City Culture. It analyzes the current construction situation of Baoding’s related websites, pointsing out their current shortcomings, while putting forward various suggestions. In addition, from the perspective of translation, the defects in the translation content of current websites has been pointed out from three perspectives: historical stories and ancient literature, proper nouns, natural scene, and providing corresponding revised translations and methods and suggestions for the translation of this type of text.

Background: Stomal site incisional hernia is a common complication following ostomy closure. Prophylactic mesh reinforcement of the fascial defect is typically not considered due to the contaminated nature of the case. The effectiveness of prophylactic mesh placement at the time of stoma closure is unknown because of fear of mesh infection and subsequent wound complications. Purpose: To compare the results obtained by placing synthetic mesh in the stoma site during closure with conventional technique without mesh to prevent incisional. Patients and Methods: Prospective interventional study had been designed to compare the outcome of permanent synthetic mesh placement at the time of ostomy closure. Total 45 patients were selected purposively who were candidates for ostomy closure and presented at the Department of Colorectal Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU) from April 2019 to September 2020 and divided into two groups (no mesh and mesh). In the mesh group, permanent synthetic mesh (ProleneTM – Polypropylene) was placed. Primary outcome, incisional stomal hernia was assessed at regular follow-up for one year along with associated morbidities. Results: The primary outcome of this study i.e. incisional hernia (stomal site) was observed among 1 (4.8%) patients at 4th week, 3 (14.3%) at 3rd month, 7 (33.3%) at 6th month and 8 (38.1%) at 12th month follow-up in no mesh group. And, only 1 patient at 6th month and 12th month follow-up had hernia in the mesh group (Figure 3). There was no difference statistically between no mesh and mesh groups at 4th week and 3rd month but significant difference found at 6th and 12th month follow-up (p=0.280, p=0.344, p=0.033 and p=0.017, respectively). Conclusion: Prophylactic placement of permanent polypropylene mesh during ostomy closure placement significantly reduced the rate of incisional hernia without any additional morbidity. Placement of mesh was found to be both safe and effective.

Background: Over the years, aligner therapy has undergone a great evolution. The use of aligners is now an alternative to braces for aesthetic reasons. Their effectiveness and impact have yet to be evaluated. Objective: The objective of this study was to compare the effectiveness of dental movements with aligners versus the use of conventional appliances, as well as the effectiveness and impact on periodontal health and root resorption. Materials and Methods: A systematic search of PubMed, Ebsco Host and Scopus was performed using a well-designed formula. Articles published in the last 10 years in English and French were included after filtering the titles, abstracts then full texts. Results: Twenty-six records were deemed suitable for the objectives of our systematic review. All records focused on the comparison of treatment with aligners and fixed appliances. The difference in treatment and time efficiency was assessed in 17 papers, 6 papers evaluated the impact of orthodontic appliances on periodontal health, and the remaining 3 records focused on the occurrence of root resorption. Conclusion: Clear aligners produce clinically acceptable outcomes that could be comparable to fixed appliance therapy. Aligners facilitate oral hygiene practices which results in better periodontal health. However, it appears that Invisalign may not be as effective as fixed appliances in achieving certain tooth movements like vertical, radicular and rotational movements.

As a form of Higher Education's Tridharma, community service through Focus Group Discussion (FGD) is needed to explore responses from students, namely Real Work Lecture participants to the economic phenomenon that is currently being rolled out by the government, namely Village-Owned Enterprises (BUM Desa). The purpose of this activity is to formulate a BUM Desa financial literacy model according to the perspective of students (participants of the Real Work Lecture) which at the same time implements the realm of knowledge received in college with real conditions in the field, namely the village. Considerations for choosing FGDs are: planned discussions, directed by trained moderators to explore participants' understanding and opinions regarding the topics discussed, namely financial literacy. The results of the FGD explained that the model applied in BUM Desa financial literacy is by integrating aspects of knowledge, skills and attitudes. Knowledge of finance is the basis for managers in managing achievements. Management skills or skills must also be owned by managers. Meanwhile, honesty is an important aspect and is inherent in financial managers.

Clinical research ethics is founded on a few well-known rules and papers. The criteria differ from country to country, but the ideals of respect for humans, beneficence, and fairness remain consistent. These values are expressed in criteria for obtaining free and informed consent, minimizing risk or damage, and without disproportionately burdening or disadvantageous specific people. In hospitals, physicians frequently confront ethical difficulties that need appropriate abilities and the capacity to detect and manage. For research to be ethical, it must also be of such high quality and performed in such a way that it produces known and usable knowledge. Youngsters have a reduced ability for comprehension and may be more susceptible to compulsion. As a result, kids are seen as a particularly vulnerable demographic, and specific provisions for children are included in many standards. The level of risk permissible for minors participating in research is an important topic in these clauses. While it is widely acknowledged that children deserve special care due to their fragility, there is growing concern that children in general should not be disadvantaged by a lack of information because of decreasing research activities. The purpose of this study was to examine the ethical issues faced by physicians and nurses with medical education and pediatric care responsibilities, as well as whether those issues are related to their workplace, medical specialty, and area of clinical practice, as well as the primary role of parents and children in adhering to these ethics.

Introduction: Fibrothecal group tumours are part of the gonadal stromal and sex cord tumours (GSST) and represent 1-4.7% of all organic ovarian tumours and are usually benign. We felt it important to report a case in order to share our experience in the management of fibrothecal tumours of the ovary. Observation: This was a 51-year-old postmenopausal patient who was referred to the hospital for abdominal pain in the context of an abdominal mass. A clinical examination and abdominal ultrasound concluded that the left ovarian tumour was benign. A left annecxectomy was performed and the histological examination concluded that the tumour was benign. No tumour marker was measured and no CT scan was performed. The postoperative course was simple and the patient was followed for 3 months.

Ketamine, an N-methyl –D-aspartate (NMDA) antagonist, has been abused as a recreational drug due to its euphoric, dissociative, and hallucinogenic characteristics. Series of studies have been carried out on the effect of ketamine on cognition and memory. However, there is dearth literature on the activities of ketamine as a recreational drug of abuse; its effect on motor response in association with cognitive behaviours in Wistar rat models. Hence, this study is necessary to investigate the effects of chronic administration of sub-anesthetic doses of ketamine on perceptual, cognitive, and motor responses in Wistar rats. 25 Wistar rats (160-180 kg) were randomly selected into five groups and treated for three weeks thus: Group 1 (control), Group 2 (0.2 mL Ketamin-i.p), Group 3 (0.4 mL Ketamin-i.p), Group 4 (0.6 mL Ketamin-i.p) Group 5 (0.5 mL Cerebrex-orally). Neurobehavioral (Barnes, rotarod, and handgrip) activities exhibited by the various groups were recorded and analyzed using ANOVA. In the Barnes maze test, there was a significant increase (p<0.05) in escape time from weeks 1, 2 and 3 in groups 2, 3 and 4 when compared to control. In week 2 and 3 of the handgrip test, animals in group 4 had a significant improvement (p<0.05) in grip strength when compared to control. In weeks 1 and 2 of the rotarod test, groups 2 and 4 animals respectively, showed a significant increase (p<0.05) in balance compared to control. Sub-anesthetic doses of ketamine inhibited cognitive function but not motor responses in Wistar rats.

Laurus nobilis is one of the most popular species belonging to the lauraceae family and it has been reported to possess many physiological properties such as antimicrobial, antifungal and wound healing effects. In this study, effects of ethanolic leaf extract of Laurus nobilis on some oxidative stress markers and liver function parameters of female Wistar rats were investigated. Five rats were randomly assigned into each of groups 1-4, of which group one (1) served as control and received distilled water. Groups 2-4 were treated with 100mg/kg bw, 200mg/kg bw and 400mg/kg bw of the ethanolic extract of the leaves of Laurus nobilis respectively, for a period of 14 days. The results obtained indicated that the superoxide dismutase and catalase enzyme activities as well as, gluthathione reductase and peroxidase activities were not significantly affected. The malondialdehyde level did not change significantly after two weeks of extract administration. The extract caused no significant (P<0.05) alteration in the enzyme activities of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), as well as serum concentrations of total protein (TP), albumin (ALB) and total bilirubin. This study have shown that extract of Laurus nobilis neither altered hepatic function parameters nor promoted toxic stress in the female Wistar rats.

Background: Breast cancer is a heterogeneous, phenotypically complex disease made up of various biologic subgroups with unique behaviors and therapeutic responses. Noted that despite lack of a cure for metastatic breast cancer (MBC), there have been appreciable advancements in survival that have occurred at the same time as newer systemic treatments. BRCA1 or BRCA2 mutations cause homologous recombination deficient (HRD) cells, which are vulnerable to PARPi agent treatment. Case Report: This case report presents a 40 years old single female, known case of multiple co-morbidities who was diagnosed with Bilateral breast cancer in June 2022. She has a Positive family history of malignancy; mother died from endometrial cancer and aunt from paternal side has breast cancer. She underwent needle core biopsy from her Right breast mass, which revealed Invasive high-grade ductal carcinoma with metaplastic features (foci of keratinizing squamous differentiation, and myxoid stromal change). DCIS, of intermediate and high grades and a solid pattern, was noted, focally suspicious for lymphovascular invasion, Triple negative (ER negative (<1%), PR negative (<1%) and her-2 (+2) FISH negative (Her-2 Low), KI 67= 70%. Left breast mass Biopsy done on 12/9/2022 showed Invasive Lobular carcinoma, grade 3, ER negative, PR negative, Her-2 +1, KI 67=70%, BRCA2 POSITIVE & PDL1 CPS score 10%. Staging positron emission tomography scan done on 10 October 2022. She had a Large hypermetabolic fungating right breast mass infiltrating the chest wall, consistent with biopsy-proven malignancy. Additional smaller FDG-avid lesions noted in the right breast. Moreover, she had FDG-avid right axillary and right internal mammary nodal metastases. Mildly FDG-avid left breast mass, consistent with biopsy-proven malignancy. FDG-avid liver and pleural metastases. She was started on PARP inhibitor (Olaparib) on 20/9/2022 after which she had amazing fast clinical response leading to falling off the large fungating mass. Conclusion: The chance of developing breast and ovarian cancer is extremely elevated if one possesses BRAC 1 or BRCA 2 mutation. In this situation, PARP inhibitors, mutation-targeted therapy, has better outcomes in reducing the morbidity and mortality associated with metastatic breast cancer (Olaparib).

The combination of gastric tumor and hiatal hernia is a rare event, that makes management delicate, and the prognosis pejorative given the risk of multidirectional lymphatic dissemination. Through this case report, we present a fully laparoscopic management, in an 80-year-old woman with a gastric tumor of the upper 1⁄3 of the stomach, associated with a huge hiatal hernia. This lady presented to the emergencies during the period of the Covid 19 pandemic, for dyspnea crisis of progressive worsening. thoraco-abdominopelvic CT showed a huge hiatal hernia explaining its symptomatology. Esogastroduodenal fibroscopy showed a cardia-gastric tumor. A total laparoscopy gastrectomy with lymph node dissection D1.5 associated with a cure of hiatal hernia were performed. The postoperative follow-up was simple and the patient declared outgoing on Day 5 postoperative.