Gastrointestinal stromal tumors are mesenchymal tumors that represent 0.1% to 0.3% of all malignant tumors. Their clinical presentation is nonspecific but presentation by massive hemorrhage with hemodynamic instability is rare. We report the cases of 02 young patients who presented a fulminant digestive hemorrhage with hemodynamic instability and whose endoscopic exploration did not reveal any obvious etiology. That’s why we involved interventional radiology and surgical team in order to localize and confirm the diagnosis of a hemorrhagic jejunal GIST and then to ensure the hemostasis by small bowel resection taking away the jejunal tumor.

Placenta accreta is a rare condition. Its incidence is constantly increasing due to the increasing number of caesarean sections (multiplied by four over the same period).Placenta accreta is responsible for major maternal morbidity and mortality. Targeted ultrasound, in the presence of risk factors, is relevant for this diagnosis. Patients with at least one uterine scar and a previous placenta previa represent a population at risk whose placenta should be examined during screening ultrasound with the full attention of the operator. The smallest diagnostic doubt should lead the practitioner to refer the patient for expert ultrasound examination. Current challenges include early detection of placenta accreta in the first trimester, prediction of the degree and extent of placental villi invasion, and prognosis assessment.

Background: Iodine is a necessary element of the hormones produced by the thyroid gland. Basically, thyroglobulin (Tg), a thyroid-specific protein, that reflects the size of the thyroid gland, is usually considered a biomarker of urinary iodine status of several patients. But in Bangladesh, we do have not enough information regarding the sensitivity, specificity, and predictive value of thyroglobulin in determining iodine deficiency among simple diffuse goiter patients. Aim of the study: The aim of this study was to evaluate the sensitivity, specificity, and predictive values of thyroglobulin in determining iodine deficiency among simple diffuse goiter patients. Methods: This cross-sectional observational study was conducted at the Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University (BSMMU), and Dhaka Bangladesh. The study was conducted during the period from May 2014 to March 2016. The targeted sample size of this study was between 39 and 90 and the final sample size was finalized as 87. A purposive sampling technique was used to select 87 patients with simple diffuse goiter attending the outpatient department of the mentioned hospital. Results: In this study, we did not find any statistically significant difference in urinary iodine between the different cut-off values of serum thyroglobulin at 14.46 (ng/ml). Similarly, there was not any statistically significant difference in urinary iodine levels at different cut-off values of thyroglobulin. Thyroglobulin had a high negative predictive value and comparatively low positive predictive value in determining iodine deficiency, at 98.51% and 30% respectively. Serum thyroglobulin had 85.71% sensitivity and 82.50% specificity. Thyroglobulin also had a high negative predictive value at 98.51%, but a low positive predictive value at 30%. The overall accuracy of thyroglobulin as an indicator for iodine deficiency was 82.76%. Conclusion: Thyroglobulin seems to have an inverse association in iodine deficiency state and a positive association in over sufficient state with UI. The overall sensitivity of thyroglobulin was satisfactory but the specificity was found very low. Considering the urinary iodine as the gold standard, basically, the positive predictive value of thyroglobulin was found very low but the negative predictive value was found very high.

Documentation of cultural heritage is basically a computerized or digital representation of objects contains the realistic portrayal of objects in 2.5 or 3D and other details. It is an unquestionable reality that the most vital thing for transmitting cultural heritage to posterity is a delicate documentation. Up to the present there have been numerous advancements in documentation of cultural heritage through technology development, and contemporary documentation techniques have progressed speedily. In time, current techniques have turned out to be desirable over conventional methods in engineering in the existent state and in assurance of disfigurements and preparation of measured drawing projects of historical edifices. Over the most recent ten years, direct 3D documentation techniques are very well known and that great advancement. Generally several main geomatics approaches are using for documentation , in first approach, image based such as close range photogrammetry, unmanned aerial vehicles, infrared (IR) images, second approach are non-image-based such as conventional measurements, terrestrial laser scanning, and In third approach, many researcher are using hybrid method that companied between different techniques. With ongoing improvements in PC and information technologies, this notable customary method has been change with digital close-range photogrammetry. This new technique offers us new open doors, for example, automatic orientation and procedure of the measurement, create of 3D vector information, advanced ortho-image and digital surface model. Laser scanning is another innovation that lately has turned out to be progressively well known for documentation which gives exceptionally thick 3D points on an object surface with high exactness. Also, the 3D model and ortho-photo can be effortlessly created utilizing produced 3D point clouds and recorded digital pictures. This paper gives an overview about the techniques related with documentation of cultural heritage and the uses of cultural heritage.

In the last decades, 3D city models appear to have been predominantly used for visualisation; however, today they are being increasingly employed in a number of domains and for a large range of tasks beyond visualisation. In the past, the virtual 3D models are being built using primary materials, (e.g. wood), because of the flexibility and easy handling of this material, where the measurements are taken in traditional methods, so that the work is done in direct contact with the target [2]. However, with the advancement and development of techniques, the virtual 3D models are produced by computer-aided design and by using of auxiliary software's such as, AutoCAD but with manual measurements[8]. To overcome these difficulties, many techniques and remote sensing devices have been developed. These techniques are considered as the leaders in this respect and are commonly used in extracting 3D models nowadays such as photogrammetry and Light detection and ranging (Lidar). These techniques provide lots of information with high accuracy standards and reliability without direct contact with the real world (except for assessment and validation purposes). In this paper, we seek to understand and document the state of the art regarding the utilisation of 3D city models across multiple domains based on a comprehensive literature study including hundreds of research papers, technical reports and online resources.

Introduction: The treatment of the atrophic posterior maxilla is a challenge, and there are different techniques for its rehabilitation with dental implants. In the present study we compare two of the most widespread: the classic lateral approach and transcrestal elevation. Material and methods: A retrospective open-mouth pilot study was carried out to evaluate the predictability of the two surgical techniques described above. To this end, patients in whom both techniques were used (one per quadrant) were followed up and a quantification of bone loss and gain over the implant apex was carried out, as well as an estimate of survival in both groups of implants. Results: Five patients were recruited and 13 implants were inserted (8 in conventional sinus lift and 5 in transcrestal sinus lift). The mesial bone loss of the implants studied at the end of the follow-up time was 0.40 mm in the mesial zone (+/- 0.23) and 0.50 mm in the distal zone (+/- 0.34) for implants placed in traditional elevations. For implants inserted in the transcrestal elevation the mesial bone loss of the implants studied at the end of the follow-up time was 0.30 mm in the mesial zone (+/- 0.13) and 0.20 mm in the distal zone (+/- 0.24). There were no statistically significant differences between the mean bone losses of both techniques (p=0.021). Conclusions: Both techniques have proven to be predictable for the treatment of the atrophic posterior maxilla in height. The use of short and extra-short implants and transcrestal elevation requires fewer surgeries and has a priori a lower risk of complications. In the patients of our split-mouth study we found no statistically significant differences between the two procedures.

Background: A covid-19 pandemic is an unprecedented event, which has a profound impact on the lives of children with neurological and neurodevelopmental disorders besides other people. In Bangladesh, the effects of the Covid-19 pandemic on children with neurological and neurodevelopmental disorders have not been adequately studied. Aim of the study: The aim of this study was to assess the diseases status of children with neurological and neurodevelopmental disorders during the Covid-19 pandemic. Methods: This voluntary prospective observational study was conducted during the period from June 2020 to August 2020 with an attachment of the department Paediatric Neuroscience, Bangladesh Shishu Hospital & Institute, Dhaka, Bangladesh, and Neurogen Health Care, Dhaka, Bangladesh. A total of 78 children with at least one symptom of neurological and/or neurodevelopmental disorders were included as the study subjects of this study. Both previously diagnosed and newly recruited patients were accumulated as the study subjects. Both physical and online (With telephonic communication) consultation and follow-up were arranged for all the patients during the study period. All data were collected, processed, and analyzed by using MS Office and SPSS version 23 programs as per need. Results: In this study, the mean (±SD) age of the participants was 9.87±2.59 years. The male-female ratio was 1.4:1. The majority of the participants were from rural areas (55) and only 2 were from Covid-19 affected. About half of the participants (49%) were with epilepsy. Besides this, ‘impairment in social interaction, communication and behavior problem’, CP with global developmental delay, syndromic child, and ‘hyperactivity and inattention were found in 22%, 13%, 10%, and 6% participants respectively. The majority of the patients (53%) of this study were under antiepileptic therapies. Besides this, 9%, 13%, 5%, 14%, and 6% of participants were taking Immunosuppressive therapies, physical or occupational therapies, psychotherapy, combination therapy, and some other therapies respectively. Conclusion: Epilepsy is the most common disorder among children with neurological and neurodevelopmental disorders who saught for online consultation. Online consultation followed by subsequent physical consultation may be considered as an effective approach in managing patients with neurological and neurodevelopmental disorders during any pandemic situation like Covid-19.

A number of policies, missions and programmes have been initiated to facilitate e-learning enabled by information and communication technologies (ICTs) over recent years both by central as well as state governments in order to enhance effectiveness of teaching-learning process. However, tangible outcomes of such initiatives have been limited so far due to a number of factors especially in government institutions. While in some cases the core reason has been availability, accessibility, adequacy and quality of ICT tools, in many cases intention to use such technologies by teachers has been found conspicuous by its absence. The present paper uses the theoretical framework of the Technology Acceptance Model (TAM) to deduce relevant lessons. The objective is not to deliberate on the nuances of the model but simply to pick out a few relevant constructs in light of the author’s own experience of technology adoption in the context of schools and colleges of Himachal Pradesh. After briefly outlining the key tenets of TAM, the paper articulates the rationale for adopting this model and finally discusses key lessons for increasing acceptance of such technologies among educational stakeholders. Since COVID 19 has already created a rationale for adopting technology-enabled learning methodologies, the recommendations of this paper are likely to improve the efficacy and effectiveness of current and future initiatives.

A fibrous which is also called as hyperplastic ridge is a superficial area of mobile soft tissue affecting the maxillary or mandibular alveolar ridges. It develops when alveolar bone gets replaced by hyperplastic soft tissue and is a common finding particularly in the upper anterior region seen in long term denture wearers. Masticatory forces often displace this mobile denture-bearing tissue, which leads to altered denture positioning and loss of peripheral seal. Forces exerted during the act of impression making results in distortion of the mobile tissue. Unless it is managed appropriately by special impression techniques, such ‘flabby ridges’ adversely affect the support, retention and stability of complete dentures. This paper presents prosthodontic management of a patient with flabby ridges with special impression technique.

Gayet-Wernicke encephalopathy is a neuropsychiatric emergency due to thiamine (vitamin B1) deficiency, secondary to several factors, it is a disorder characterized by confusion of acute onset, nystagmus, partial ophthalmoplegia and ataxia. The diagnosis is mainly clinical. The disorder may resolve with treatment, persist, or degenerate into Korsakoff's psychosis. We report a case of Gayet-Wernicke encephalopathy in a 39 year old non-ethylic patient, pregnant at 17 weeks of age who presented with consciousness disorders with paresthesia of the 4 limbs and dyspnea. Clinical and magnetic resonance imaging (MRI) have an important place, especially in the diagnosis of non-alcoholic Wernicke's encephalopathy.

Amidst the corona-virus pandemic, universities around the globe had to switch the provision mode of higher-level education and students’ assessment from face-to-face to online ones, without adequate preparation. Given this new educational reality, this study set out to explore undergraduate Greek students’ points of view regarding the computer-based assessment that was implemented at their university Department under the covid-19 circumstances. Twenty-nine learners were purposefully and voluntarily recruited to participate in the research. Data were collected using as a research tool the spontaneous texts written by the students, while qualitative content analysis was used for the data analysis. Overall, findings indicated that most of the participated students were in disfavor with the computer-based assessment, stating mainly the disadvantages that this process entailed. As the most cited drawbacks, these were found to be the technical problems that used to arise, followed by the inadequate time assessees had for their assessment as well as the students’ concerns about academic integrity. Still, most students found their experience with the computer-based assessment conducted unique and weird. While these findings do not support previous research, they are fully discussed in terms of their implications in the article.

The rudimentary uterine horn belongs to the group of major uterine malformations according to the classification of Musset's classification. This rudimentary horn may have a cavity with endometrial lining of the uterus, and thus can serve as a site of implantation during pregnancy. The presence of a pregnancy in a rudimentary horn is a rare event, which can be revealed by a uterine rupture. It leads to an emergency fetal extraction and it is then recommended to perform an exeresis of this rudimentary horn [6, 7]. If it is not performed, it theoretically exposes the risk of recurrence of uterine rupture in case of a new pregnancy in this rudimentary horn. There is a need to increase awareness of this disease, especially in developing countries where the possibility of detection of the disease is limited. We report a case of ruptured rudimentary horn pregnancy in shock at 23 weeks of gestation misdiagnosed as intrauterine pregnancy. The pregnancy was located in a rudimentary left uterine horn ruptured on its posterior surface and communicating with the right horn. A hemi hysterectomy was then performed with the removal of the rudimentary horn and the homolateral adnexa. The fetus was deadborn. The postoperative course was simple and the patient was discharged on the fifth postoperative day.

Job satisfaction is considered one of the most important parameters in measuring the performance of the employees. In this study, the researcher has discussed different factors that lead to dissatisfaction among expat nurses working in the Saudi healthcare sector, and has used positivism philosophy. Different survey instruments were used to collect primary data for this study: and the JSS (quantitative component). Firstly, nurses were provided with a self-administrated JSS. The JSS was developed to analyse nine job satisfaction scales, each containing four subscales. The reliability coefficient for descriptive statistics was computed at 0.84, above the threshold mark of 0.70. T-tests were used in this research. During the study, it was observed that out of the 100 married participants, 43 were at the position of Charge nurse and only one of them was working as a director in the organisation. The researcher conducted t-tests to identify the factors that lead to job dissatisfaction among the expats at Hali’s public hospitals in Saudi Arabia. Herein it was observed that very few chances of getting a promotion were of the main causes of job dissatisfaction among the expat nurses. Here the p-value was 0.00, lower than the threshold requirement of 0.05. In conclusion, the chances of getting a promotion were very less due to the fact that they were not native to the country. Also, nurses were not happy with the benefits that they receive in the organisation. That is, expats do not get too many benefits in the host nations.

Assessment of the financial performance of banks is very important to be carried out by internal organizations and as a basis for corporate planning in the future. The financial performance in question is related to CAR, NPF, BOPO and FDR which theoretically and empirically affect bank profitability, namely ROA. The objectives of this study are: (1) to examine the effect of CAR on ROA; (2) examine the effect of NPF on ROA; (3) examine the effect of BOPO on ROA and (4) examine the effect of FDR on ROA. The Islamic Commercial Banks that are the locus of this research are BRI Syariah and BNI Syariah which represent Bank Syariah Indonesia before the merger in 2021. The research data is taken from the documentation of the two banks published by the Financial Services Authority of the Republic of Indonesia, from 2015 to 2020 in the form of data quarterly. The results of testing the research hypotheses can be stated: (1) CAR has a significant effect on ROA; (2) NPF has no significant effect on ROA; (3) BOPO has a significant effect on ROA and (4) FDR has a significant effect on ROA.

Objectives: The aim of our study is to look for the different Gram + and Gram - germs present in the biofilm of thermoplastic appliances and to note the qualitative modifications of the aligners’ bacterial flora after the use of the tea tree essential oil. Materials and Methods: Thirty-four patients were involved in the study. They were divided into two equal groups: a control group using a toothbrush and toothpaste as cleaning means and a test group using the tea tree essential oil as a supplement. Results: The results showed that the bacterial flora of the thermoplastic device is very diverse with a predominance of the genus Staphylococcus. It was isolated in more than half of the devices used by the control group. In terms of species, Enterobacter cloacae complex and Staphylococcus aureus were the most represented. In addition to the bacteria, usually found in the oral cavity, several other non-oral strains were frequently isolated, underscoring the importance of hand hygiene. The tea tree essential oil showed its effectiveness on Staphylococcus, which was significantly less encountered in the test group (p = 0.031). Conclusion: Thermoplastic appliances contain a diverse bacterial flora; Tea tree essential oil can be used for disinfecting purpose.