Background: The haematological changes are common in cirrhosis of liver the cause of which is multifactorial. It should be correlated by determining the underlying pathology accordingly. Objective: The objective of the study was to evaluate the pattern of change in Haematological indices in Cirrhosis of liver. Methods: This is a cross sectional prospective study conducted on purposely selected (non-probability) hospitalized patients admitted to Medicine, Gastroenterology and hepatology departments of Dhaka Medical College Hospital, Dhaka, Bangladesh. A total of 100 cases of cirrhosis were selected as per inclusion and exclusion criteria. After selection clinical history, meticulous physical examination and rational investigations were done. Data were collected as per a structured standard questionnaire and checklist. Data analysis was done using statistical software package SPSS 22.0 and was compared with other studies. Results: Anaemia was found in 81 cases out of 100 patients. Anaemia was morphologically normocytic in 46% patients which is the highest number in this study group. It was microcytic in 40% patients and macrocytic in 14%. Regarding Leukocyte count it was normal in 70(70%) patients, Leukopenia in 12(12%) and Leukocytosis in 18(18%) patients. Regarding platelet count it was normal in 46(46%), thrombocytopenia in 51(51%) but thrombocytosis in 3(3%) of cases. The average platelet count in thrombocytopenic patients was 90 X 1091 ± 23 X 109/L. Lastly, pancytopenia was present in 14(14%) patients. Among them, 10 patients (71%) had splenomegaly. Iron Profile was done in all patients of microcytic anaemia and it revealed 68% of them were iron deficiency anaemia. Prothrombin time was done in all patients and it was prolonged in 54 (54%) and its average value was 16.13±.2.9 seconds. Conclusion: Haematological changes are common in cirrhosis of liver, the cause of which is multifactorial. Iron deficiency anaemia is the common type (68%).Prolong prothrombin time (54%) and thrombocytopenia (51%) are the common features.

Background: Stabilization of weather factors especially temperature, pressure and humidity in bunkers that housed the Linear accelerators is necessary for safety of equipment and their efficient function for our patients. Daily variation of such factors can lessen the performance of Linear accelerators resulting to an error in their output and wrong dosimetry. Sokoto centre being located in the North-Western region of Nigeria with three unique seasons (Dry hot, Harmattan winter and Wet raining seasons) require a study of this kind to ascertain the influence of those harsh environmental factors on bunker's internal air condition. Methods: Daily records of Linac bunker temperature and pressure were measured using Precision mercury-in-glass thermometer and Opus barometer (OPUS 10 THI) from January 2019 to December 2021. Similarly, the corresponding daily external environmental temperature and pressure for the study period were obtained from Nigerian Meteorological Agency. The values were grouped according to the months of year, mean values of temperature and pressure for each month of the year were generated and graphs and bar-charts were plotted for both bunker and external environment. Similarly, an overall mean score for both temperature and pressure of each month of the three years period were generated and graphs were plotted with those values for bunker and external environment. Results: The overall mean external temperature for the study period was 35.7°C, ± 3.82 as standard deviation (SD) and with a range of 26.0 – 43.6 °C, while for the overall mean bunker temperature it was 27.1°C ±1.7 SD and a range of 23.1 - 31°C. For the external environmental pressure, the overall mean value was 78.1hpa ± 1.5 as SD and a range of 68.1– 83.1hpa, while for the bunker it was 977.2 hpa ± 2.55 as SD and a range of 966.9 – 988.7 hpa. Using the pearsons correlation, it indicate that there is a significant association between environmental and bunker temperature (p-value=0.002). Conclusion: External environmental temperature showed a significant influence on bunker temperature despite the presence of chillers. But for environmental and bunker pressure, the relationship is complex and non-significant. Similarly, the seasons of the year also influenced bunker temperature.

Introduction: Insular carcinoma is a rare tumour with frequent tumour necrosis and micro follicles. Materials and Methods: Female patients with swelling in front of neck, USG and FNAC were carried out. FNAC showing follicular neoplasm were followed up with histopathology and 2 cases are presented here. Observation: Two female cases with swelling in front of neck with cytology depicting follicular neoplasm were studied. Discussion: Insular carcinoma of thyroid arises from follicular epithelium hence have abortive follicles with necrosis. Its prognosis lies between well and poorly differentiated thyroid carcinoma. Conclusion: It is necessary to recognize the tumour for better prognosis.

Background: Palliative external beam radiotherapy (PRT) had been reported as an indispensable tool for an effective pain relief in cancer patients with metastatic bone pain. Although many scholars reported a link between pain perception and ethnic background of an individual, but its role in cancer patients with interplay of other tumour factors needs to be evaluated to ascertain the actual impact it may have on pain perception and responses to radiation analgesia. Methods: We retrospectively reviewed patient’s data of breast cancer with metastatic bone pain between 2015 and 2018. Patient’s demographic factors like age, sex, ethnic group, tumour histology, RBS grade and sites of metastasis were extracted and grouped accordingly. Other Radiotherapy doses used for palliation of pain were extracted. Visual analogue pain assessment scale (0-10) was used by doctors (majority from Hausa-Fulani ethnic origin) to asses’ pain at presentation and four weeks post-irradiation. SPSS version 23 was used for data analyses; univeriate and multivariate analyses were conducted to test for any significant associations between predictive factors and dependent variables. Results were presented in pie-charts, bar-charts and tables. Results: A total of 161 patients reviewed during the study period, 159 (99%) were females and 2(1%) were males with mean age of 45.2 years, the age groups of 20-29 yrs presented with highest pain score. Among the three major ethnic groups, Yoruba constituted 31.7% with mean pain score of 7.5 ±1.4, followed by Igbo (26.1%) with mean pain score of 7.1 ±1.4. The commonest histology were invasive ductal (IDC) and invasive lobular (ILC) carcinoma with each having 7 as the highest mean pain score. Patients with grade 2 and 3 were the commonest and presented with mean pain score of 6.9±1.4 and 6.7±1.6 respectively. Patients with spinal cord compression (5.6%) presented with highest mean pain score of 7.3±1.3, followed by metastasis to long bones with pain score of 7.0±1.5. Pain alone was the highest presenting symptom (92.5%) from bone metastasis and Conventional X-ray was the common imaging modality used in confirmation of metastatic sites (68.3%). Common palliative radiation doses used were 11-20Gy in 4-6# (60%). Overall mean pain score at presentation was 6.8 ± 1.5 and 0.6 ± 0.7 four weeks after irradiation. In univariate analysis (binary comporason) only ethnicity was highly significant (p-0.001) in pain perception pre-radiotherapy and the significance exist after controlling other influential factors using multivariate analysis (p< 0.001). In post-irradiation using univariate analysis, ethnicity and metastatic sites shows significant association with pain relief, after multivariate analysis when influential factors were controlled, it appeared only metastatic sites with p-value of 0.008. Conclusion: Ethnicity of three major tribes in Nigeria played a role in pain perception from bone metastasis at presentation, with Yoruba higher pain perception compared to Hausa-Fulani and Igbo. But ethnicity appeared insignificant in response to radiation analgesia. Similarly, tumour factors appeared in significant in pain perception and response to radiation analgesia. However, metastatic sites influence response to radiation analgesia, with good pain relief in patients with metastasis to ribs and long bones.

of the jaws. Rather than true neoplasm, odontomas are considered to be hamartomas. Usually odontomas are found to be asymptomatic, although a few incidences of swelling, delayed eruption of permanent tooth and in severe cases, infection or lymphadenopathy has been reported. Multiple complex odontomas pose a therapeutic challenge in some cases especially in the mandible due to proximity of vital anatomic structures. They have also been associated with complications like cystic transformation. Here we are presenting a case of multiple complex odontomas in the maxilla and mandible in a 32-year-old male patient.

The term “pigmentation of oral mucosa” is applied to a wide range of lesions or conditions featuring a change of color of oral tissues. Common causes of mucosal coloration including petechiae, purpura, ecchymoses, hematomas, vascular tumors and exogenous substances are not true pigmented lesions. In contrast, melanin which is synthesized by melanocytes, is a true pigment and usually imparts a brown, blue or black appearance of the mucosa. Oral pigmentation affects about 3%of the total population and most likely in those with dark skin, more prevalent in females than males during the 3rd or 4th decade of life. In this review, we are describing the oral manifestation and dental considerations associated with common pigmented disorders which will allow the practitioner to have a holistic approach in diagnosis and management of these patients.

Background: In Ayurvedic classics Diarrhoea is described with the name of Atisaar. In modern science it is closely correlated with watery Diarrhoea which is defined as having loose or watery stools at least three times per day or more frequently than normal for an individual. Diarrhoea caused by bacterial pathogens is a global health problem, especially in developing countries and enteric bacterial pathogens are the main cause of infectious Diarrhoea. Ayurvedic literature have lot of unexplored or least tested medicine, Shadanga Ghrita is one of those Ayurvedic formulation used in the management of Tridoshaja Atisaar. But it has some disadvantages such as bitterness in taste, unpalatability, feasibility and inconvenience in transportation. Considering these, here an attempt was made to transform it into a new dosage form i.e., Ghana Vati. Aim & Objectives: Aim & objectives of present study was to evaluate the anti-bacterial activity of Shadanga Ghrita and its new dosage form on Diarrhoea causing enteropathogens. Material and Methods: Samples of Shadanga Ghrita & its Ghana Vati were prepared as per Sharangdhar Samhita Madhyama Khanda. All the samples of finished products were analyzed on organoleptic and physico-chemical parameters. Anti-bacterial study was done by using Well Diffusion Method and Muller Hinton Agar Media was used to evaluate anti-bacterial activity against S. aureus, E. coli, S. enterica, S. boydii, Y. enterolitica, A. species, and C. perfringens. Result: Both samples showed significant anti-bacterial activity against Diarrhoea causing enteropathogens. Conclusion: Shadanga Ghrita is more effective Antibacterial agent, as it was formulated by Sneha Paka Kalpana method; Gou- Ghrita has potentiated the anti- bacterial effect of it.

MTA® is considered as the biomaterial of choice because of its excellent characteristics. Biodentine™ has been introduced into periapical surgery and has proven its efficacity in sealing root-end cavities. Despite of the desirable properties of BiodentineTM, there are limited published cases that described the use of BiodentineTM in periapical surgery.

This study aims to analyze the effect of organizational structure and readiness for change on employee engagement and good governance at the Department of Cooperatives, SMEs and Industry of Samarinda City. The sample is 71 permanent employees of the Department of Cooperatives, SMEs and Industry of Samarinda City who are involved as respondents and are given a questionnaire containing questions that must be answered by giving a score. The data analysis method used is the Structural Equation Model (SEM) analysis using the SmartPLS application. The results showed that there was a significant influence between each organizational structure on employee engagement, readiness for change on employee engagement, readiness for change on good governance, and employee engagement on good governance. However, it is found that readiness for change on good governance does not have a significant effect. Based on the results of the study, almost all variables have a significant effect, but only readiness for change on good governance does not have a significant effect, so whatever changes the organization do, employees of the Department of Cooperatives, SMEs and Industry of Samarinda City some are being not able or even not willing to implement the changes.

Introduction: Despite ongoing advances in the treatment of chronic kidney disease (CKD), the mortality rate, and level of health-related quality of life (HRQOL) for the CKD population remain significantly higher than for the general population. The importance of measuring end-stage renal failure (ESRF) patients' quality of life in relation to healthcare lies in not only providing absolute survival but also the quality of that survival. Due to cost constraints, the profile of chronic kidney disease patients and their treatment in Bangladesh is almost identical to that of India, with patients frequently requesting a reduction in the frequency of dialysis sessions, the use of less expensive dialyzers, dialyzer reuse, and the absence of erythropoietin therapy. Hence, augmenting the QOL may perhaps be a challenge and an observable fact of specific interest for renal healthcare teams. This study is intended to assess KDQOL among patients receiving hemodialysis for 8 hours, and 12 hours per week, patients receiving CAPD, and patients of CKD stage V who decline any form of renal replacement therapy, and remained on conservative treatment. The aim of the study was to assess the quality of life among patients of CKD Stage V. Methods: This cross-sectional study was carried out at the Department of Nephrology, Dhaka Medical College Hospital and BIRDEM general hospital. The patients who received consultation at the Outdoor Department of selected hospital from November 2010 to October 2011. The study assess the of Quality of Life, and Cost Effectiveness on different modalities of treatment among the patients of chronic kidney disease stage V, and also to find out the best modality of dialysis. A total number of 134 consecutive patients were enrolled in this study, out of which 42 patients who were advised to commence renal replacement therapy, and after counseling opted to remain in conservative treatment were considered as GROUP I, 39 patients who received hemodialysis 8 hours per week were considered as GROUP II, 30 patients who received hemodialysis 12 hours per week in one or more centers were considered as GROUP III, and 23 patients who received Continuous Peritoneal Dialysis at least 3 exchanges per day were considered as GROUP IV. Result: Mean age was almost similar in all four groups, and most of the patients were 5th decade, and above. Male was predominant in all four groups, and the male-female ratio was almost 2:1 in the whole study patients. Diabetic nephropathy and glomerulonephritis were more common etiology of CKD in all four groups. Monthly expenditure was significantly (p<0.05) higher in group IV, followed by group III, group II, and group I in all three follow-ups, however, monthly expenditure was almost similar between group III, and group IV (p>0.05) but the mean monthly expenditure was higher in group IV patients. Mean serum Creatinine was lowest in group IV followed by group III, group II, and group I in descending order. Serum albumin was low in all the groups but almost parallel in all follow-ups in group II, groups I, and group IV, whereas the lowest was in group II followed by group I and group IV, but declined in group III during the 2nd, and 3rd follow-up from 1st follow-up. Hemoglobin level consistently remained within the target range in group IV in all follow-ups but below the target range in group I followed by group II, and group III in ascending order. The physical component score increased significantly in Group III, and Group IV at consecutive follow-ups, however, it was higher in Group IV. Similarly, the mental component score was recorded highest in Group IV, followed by group III, group II, and group I. Regarding mortality, it was observed that more than half of the patients were expired in group I, one-third in group II, and 16.7% in group III, and only 8.7% in group IV during final follow-up. Conclusion: Patients receiving continuous ambulatory peritoneal dialysis achieved the best clinical parameters in terms of control of blood pressure, and volume overload. On the other hand, parameters were a lot away from the desired target in patients receiving hemodialysis for 8 hours per week, and they did not have significantly better parameters in comparison to those who were only on conservative treatment. The scenario of serum albumin, and serum creatinine, though complicated by the existence of malnutrition, were in best approximation to the desired level in these patients. According to the age-sex-matched risk categorization of the patients, it was found that the majority of patients on conservative treatment were in more than the average risk category.

The present work mainly emphasized on the enhancement of solubility of Ticagrelor by developing Self- Micro emulsifying drug delivery system. Ticagrelor is a BCS class IV drug with poor aqueous solubility and permeability. The saturated solubility of Ticagrelor in various oils, surfactants and co-surfactants was determined by using UV-spectroscopy. The excipients were selected based on their maximum solubility and compatibility for Ticagrelor. SMEDDS formulations od Ticagrelor were developed using different oils, surfactants and co-surfactant combinations (4:1 and 3:1). Pseudo ternary phase diagrams were constructed and based on pseudo ternary phase diagrams, Nano emulsification area was evaluated .Formulations were designed based on the pseudo ternary phase diagram using various proportions of oil (Capmul MCM E8 EP), surfactant (Labrasol), co-surfactant (PEG-400). The prepared formulations were selected among them F1 was optimized and carried out for further evaluations like dispersibility test, self-emulsification time ,phase separation and stability test, thermodynamic stability studies, droplet size and zeta potential, invitro drug release studies. The results of present study demonstrate that Ticagrelor SMEDDS can be used as a potential means for improving the solubility of Ticagrelor.

Background: Vesico-vaginal fistula (VVF) is still a persisting scourge in the developing countries with devastating medical and social consequences. These consequences were studied among patients presenting with vesico- vaginal fistula in Sylhet MAG Osmani Medical College Hospital, Sylhet. Objectives: To analyzethe vesico-vaginal fistula patients during the 2 years period. Materials and Methods: This was a descriptive and cross-sectional study conducted in the Department of Obstetrics and Gynaecology, Sylhet M.A.G. Osmani Medical College Hospital, Sylhet from May 2008 to April 2010 (2 years).Fifty-three hospitalized patients with vesico-vaginal fistula were selected by Inclusion and exclusion criteria, undergoing repair operation irrespective of age. After selection of the patients informed written consent was taken. Each patient was interviewed using the semi-structured questionnaire containing socio- demographic and other relevant information like age, occupation, education of the patient and her husband, age at marriage, age at 1* child birth, monthly income and detailed history of the delivery. Type of fistula and related examination of the fistula was also done and noted. Type of repair of vesico-vaginal fistula, postoperative complications and outcome was recorded in the same manner. Results: The mean age of the patients with vesico-vaginal fistula was 30.5 years (SD± 8.5; range, 18 to 52). Majority (73.6%) were between 21 to 40 years; and 52.8% patients were primipara, 81.1% patients were illiterate and 69.8%patientswere from lower social class. The aetiology of fistula were obstructed labour 49.1%, emergency lower segment caesarean section 37.7%, destructive delivery 11.3% and caesarean hysterectomy 1.9%.The repair operation was done of all patients in this series through vaginal approach. Repair was done first time in 83% and rest had history of failed repair. Postoperative complications were catheter block and urine leakage in 37.7% and urinary tract infection in 11.3% patients. Successful outcome was found in 79.2% cases. Causes of failure were severe scaring 36.5% difficult operation, catheter block and others each constituted 18.2% and large fistula 1.9%. Conclusion: Young primi are the victims of vesico-vaginal fistula, obstetric causes add up to form a major share of the etiology of vesico-vaginal fistula. Proper perinatal management is most important to reduce obs fistula formation.

Background: Irreversible pulpitis occurs due to infection and other factors. Irreversible pulpitis needs root canal treatment to relieve the pain and achieve restoration of healthy teeth. The success rates of root canal treatment are based on adequate removal of the microorganism and the prevention of the re-growth of microorganisms. However, endodontic treatment isn't always successful. There are many factors affecting the outcome of root canal treatment. Aim: To identify the factors affecting the outcomes of root canal treatment by reviewing the previous studies conducted on this subject. Methods: PubMed, Google Scholar, and Research Gate databases were explored to search for articles related to our subject. The searching process involved using different keywords that were used in different combinations to obtain all possible articles focused on our subject. The inclusion criteria for studies were articles published in 2017 until now, English original and full-text articles. Results: A total of 158 articles were obtained, and only seven articles were eligible for the inclusion criteria. Four studies included treatment performed by dental students. The success rate of treatment ranged between 63.7% and 86.8%. The factors that affected the outcome of root canal treatment were categorized into factors associated with successful treatment, failure of treatment, and factors with no impact on treatment. Conclusion: The success rate of root canal treatment in our analysis was moderate. There were many factors affecting the root canal treatment outcome, including quality of filling, length of filling, and the absence or presence of a periapical lesion.

This study examines the sociolinguistics implication of the use of Nigerian Pidgin among HNDII students of the Federal Polytechnic, Nasarawa. Pidgin emerges when people from different linguistic backgrounds need a means of verbal communication. Interviews and direct observation methods of investigation are used as means of gathering data for the study. Fishman’s theory of domain analysis is employed as a framework of analysis for the study. The study discovered the presence of Nigerian Pidgin on campuses and how it affects to a great extent the teaching and learning of Standard English in Nigerian higher institutions. This study has also been able to provide answers to such questions as who speaks Nigerian Pidgin, to whom, where and for what purpose. The implication of the use of Nigerian Pidgin in academics was also explored. On the whole, this research concludes with the notion that Nigerian Pidgin is used as a means of informal communication among students on Nigerian campuses; as such, it has negative implications on the teaching and learning of Standard English in our educational process.

The study examined the effects of socioeconomic determinants on educational outcomes in Nigeria. This study was done against the backdrop that the education sector of Nigeria has failed to produce quality educational outcomes needed for the growth of the nation’s economy despite enormous works on the topic by most scholars who failed to account for the combination and extent of the effect of infrastructure, ICT, per capita income, and corruption on education outcome in Nigeria. The study was carried out to investigate the effect of infrastructure, ICT, per capita income, and corruption on educational outcomes in Nigeria using time series data covering a period of 21 years (2000- 2020). The study employed the Autoregressive Distributed lag (ARDL) bounds testing approach to ascertain the relevant relationship while the ECM captured the speed of short-run adjustment to long-run equilibrium. The findings reveal that infrastructure and per capita income have a positive effect on education outcomes (with literacy rate as a proxy) in Nigeria with only infrastructure being statistically significant. The study also found that ICT and corruption negatively and insignificantly affect education outcomes in Nigeria. The study, therefore, recommends that emphasis should be shifted from education for all to learning for all, improvement in infrastructure, and incorporation of ICT in education to aid teaching and learning.