Introduction: Paraganglioma or chemodectoma of the carotid corpuscle or carotid glomus is a relatively rare neoplasm of slow progression, late diagnosis and uncertain prognosis. This tumor originates from the chemoreceptors of the carotid bifurcation and clinically presents as a laterocervical mass. It represents the majority of paragangliomas of the head and neck (60-70%). Observation: We report the observation of a 56-year-old female patient who consulted for a right laterocervical swelling without any other associated clinical signs. A complete radiological workup (Angioscanner/Angiography) will confirm the vascular nature of the lesion, characterize the size of the mass, its nature, its mapping, and its relationship to adjacent organs. Surgical excision had confirmed the diagnosis on histopathological examination. From this observation, we review the clinical, radiological and histopathological features of this tumor, as well as its uncertain evolutionary mode and the therapeutic modalities. Conclusion: Lateral cervical paragangliomas remain rare and poorly known affections which require an early diagnosis and a multidisciplinary management: ENT surgeon, vascular surgeon, oncologist and radiotherapist according to the evolutive forms.

Introduction: Left vocal cord palsy by Compression of the left recurrent nerve by the left atrium in tight mitral stenosis defines Ortner's cardio-vocal syndrome. The vascular etiology of compression thoracic aortic aneurysm is well described in the literature. Left vocal cord palsy by Compression of the left recurrent nerve by the left atrium in tight mitral stenosis defines Ortner's cardio-vocal syndrome. The vascular etiology of compression thoracic aortic aneurysm is well described in the literature. Case Record: We present the case of an 80-year-old man with a history of thoracic trauma and recent onset dysphonia and simultaneous discovery of an aortic isthmus pseudoaneurysm and left vocal cord paralysis. Discussion: The place of dysphonia during post traumatic false aneurysm of the aortic isthmus is commented. This observation documents the mechanism of compression of the recurrent left nerve by a post-traumatic false aneurysm of the thoracic aorta. Adequate management can improve the patient's prognosis and quality of life.

Aim- To compare and correlate between antegonial notch depth, symphysis morphology and ramus morphology in different skeletal patterns in Class I, Class II and Class III relationships. Methodology: 72 lateral cephalogram and orthopantomograms were be divided into three groups according to the skeletal parameters. Each group is subdivided into three groups based on Y axis: average skeletal pattern Horizontal skeletal pattern and Vertical skeletal pattern. Cephalometric linear and angular measurement and antegonial measurement using OPG were taken. Results and conclusion: The antegonial notch depth, symphysis height, symphyseal ratio was found to be highest in Class III Vertical skeletal pattern. Symphysis depth, ramal width was found to be highest in Class II Horizontal skeletal pattern. The symphysial angle was highest in Class I Horizontal skeletal pattern. The ramal height was more in Class III Horizontal skeletal pattern and least in Class II Vertical skeletal pattern. Antegonial notch shows strong positive corelation with symphysis height in Class III Horizontal skeletal pattern, and ramal height in Class III Average skeletal pattern. Symphysis height shows strong positive correlation with ramal height in Class I Average skeletal pattern, Class II Horizontal skeletal pattern, Class II Average skeletal pattern and Class III Horizontal skeletal pattern. Symphysis depth shows strong positive correlation with ramal height in Class II Horizontal skeletal pattern and Class III Average skeletal pattern, symphysis angle shows strong positive correlation with Class III Horizontal skeletal pattern.

To cure ailments, the global population makes medicines from plants. Ficus palmata can be used to cure a variety of ailments. The purpose of this study was to examine the phytochemical content and antibacterial activity of methanol extract from Ficus palmata fruit and leaf crude extract. Maceration was used to make the methanol extracts, which were subsequently fractionated. The crude extracts and fractions were subjected to standard phytochemical screening assays. Phytochemical screening revealed the presence of flavonoids, alkaloids, saponins, tannins, polyphenols, anthraquinones, steroids, coumarins, and terpenoids in the crude methanol fruit extract. Phytochemical screening revealed the presence of flavonoids, alkaloids, tannins, polyphenols, anthraquinones, steroids, and terpenoids in the extract. The determination of trace metals in leaves and fruit samples using a flame atomic absorption spectrophotometer revealed that the fruits contained relatively high quantities of iron and other nutritionally essential elements, such as magnesium, calcium, and copper, whereas the leaves contain a high level of calcium, magnesium, and iron, as well as a small amount of copper.

Introduction: Acute leukemia is the most common form of cancer in children, platelet transfusion is needed for the chemotherapy of acute lymphoblastic leukaemia children. Platelets are transfused for therapeutic and prophylactic purposes. Transfusion of stored platelet concentrates (up to 5 days) has been demonstrated to be as effective as transfusion of fresh platelet concentrates (upto 24 hours). Platelet refractory cases were also observed in this study that was detected by Corrected Count Increment (CCI) and Percent Platelet Recovery (PPI) at 1hour and 24 hours. Aim of the study: The aim of this study was to observe the platelet refractory cases after transfusion of fresh and stored platelet in acute lymphoblastic leukemia (ALL) in a tertiary care hospital, Dhaka. Methods: A cross-sectional study was conducted in the Department of Clinical Pathology, Paediatric Haematolo- Oncology and transfusion Medicine BSMMU, Department of Haematology and Paediatric Haemato-Oncology in Dhaka Medical College Hospital from March 2010 to February 2011 where 81 children diagnosed with acute lymphoblastic leukaemia were taken as the study population. Non probability purposive sampling was used by fulfilling the inclusion criteria. Ethical consideration was taken by the BSMMU ethical review committee. A data sheet with two parts (Part A and Part B) was designed with a view to collect data from the patients to be enrolled in the study. Data were analyzed using the SPSS version 25.0. Results: Out of 81 in 47 children with acute lymphoblastic leukemia (ALL), fresh platelet concentrates (FPC) (upto 24 hours) or day-0 platelets were transfused. In 34 children, stored platelet concentrates (SPC) (days 1–5) were transfused. In 27 cases, platelet concentrates were transfused both fresh and stored. In FPC and SPC, the corrected count increment at one hour (CCI 1h) was 20.5×109/L and 18.9×109/L respectively. FPC and SPC values for the mean corrected count increment at 24 hours (CCI 24h) were 15.5×109/L and 13.8×109/L respectively. Platelet refractory cases were 15(18.5%) out of 81 cases transfused. Platelet refractory cases were 7(15%) out of 47 cases transfused with FPC and 8(23%) out of 34 cases transfused with stored platelet concentrate (SPC). There were no significant differences (P<0.05) between FPC and SPC according to platelet refractoriness. Conclusion: In vivo quality of freshly generated platelet (upto 24 hours) versus stored platelet concentrates (up to 5 days) were determined after 1 hour and 24 hours. 1-5 day’s stored PRP-PCs are as effective as fresh PRP-PCs for sufficient platelet increment.

Background: The severe respiratory syndrome coronavirus (COVID-19) pandemic has affected many aspects of life, much vaccine adopted to minimize morbidity and mortality due to COVID-19. Aim: To assess behavior changes after taken second dose of COVID-19 vaccine among students in university of Hail. Methodology: This cross-sectional questionnaire based study involved 350 participants from Hail University, Saudi Arabia. We distributed online questionnaire to determine differences in the protective measures before and after the second dose of COVID-19. Results: We included 350 participants from Hail University in Saudi Arabia in this study. Declines at different levels was detected in all protective measures after the second dose of COVID-19 vaccine that were in the questionnaire compared to before taking the second dose of COVID-19 vaccine. The significance of the behavior changes after receiving second dose of COVID-19 vaccine compared to behavior changes before receiving second dose of COVID-19 vaccine (P<0.0001). Conclusion: the second dose of vaccine resulted noticeable changes in preventive measurement behavior in university of Hail students.

This semi-systematic review aimed to quantitatively map and identify data gaps in the patient journey touchpoints for depression in Kingdom of Saudi Arabia namely disease prevalence, awareness, screening, diagnosis, treatment, adherence and management. A structured search was conducted using the predefined inclusion criteria to identify relevant studies from Jan 2010–Dec 2019. To address the data gaps, an unstructured literature search and anecdotal data were also included. Data obtained were synthesized and simple or weighted mean was calculated. Of the 2,025 articles retrieved from structured and unstructured search, eight were included for final analyses. Two anecdotal data sources recommended by the local experts were also included. Most of the articles included were cross-sectional in design. The overall prevalence of depression was estimated at 18.2%. Synthesized evidence indicated that 41.8% of the patients had awareness, 44.9% received treatment and 40.7% adhered to treatment. According to anecdotal evidence, the rate of screening and diagnosis of depression was 35.0% and 55.0%, respectively, of which 60.0% of the patients achieved symptom remission. Lack of data in patient journey touchpoints for depression in Saudi Arabia highlight the need for more evidence based studies. This might improve patient care and support national level decision-making.

The study aims to analyze the effect of organizational culture, compensation and motivation on employee performance through work discipline. The design of this research is explanatory research. In this study using the type of descriptive research with a sample of 66 respondents who are employees at PT Astra Credit Company (ACC) Samarinda. Data collection techniques using questionnaires such as questionnaires. In the sample using a purposive sampling method. This research using a Structural Equation Modeling-Partial Least Square (SEM-PLS) approach to analyze data. Reseach results show that: (1) organizational culture has a significant positive effect on employee performance, (2) compensation has a significant positive effect on employee performance, (3) motivation has not significant effect on employee performance, (4) work discipline has a significant positive effect on employee performance (5) work discipline as a mediator doesn’t act as a mediator on the effect of organizational culture on employee performance, (6) work discipline as a mediator does act as a mediator on the effect of compensation on employee performance, (7) work disciplne as a mediator does act as a mediator on the effect of motivation on employee performance.

Small-bowel capsule endoscopy (SBCE) is used widely because of its non-invasive and patient-friendly nature. SBCE can visualize entire small-intestinal mucosa and facilitate detection of small-intestinal abnormalities. Indications for SBCE are obscure gastrointestinal bleeding, Crohn’s disease, small-intestinal polyps, tumors and celiac disease. Materials and methods: We report a study from September 2018 to February 2022, including 59 patients who underwent SBCE type PillCam SB3®. All our patients previously had a normal endoscopic assessment (oesogastro-duodenal fibroscopy and ileo-colonoscopy). CT enterography and MR enterography realized in 54.2% of cases were normal. The preparation used is PEG (2l the day before and 0.5l after ingesting the capsule) with clear broth the day before the examination and 10 days off oral iron if taken. Results: The mean age was 53.9 years, with a female predominance (sex ratio: 0.52). 16.9% of the patients had a history of heart disease, 8.4% are chronic renal failure, 5% are followed for Crohn's disease and 3.3% for celiac disease. 10.1% of patients were on anticoagulants and 5% on antiplatelet agents. The indication for SBCE was Obscure gastrointestinal bleeding (OGIB) in 86,3%, Crohn's disease (CD) in 5%, celiac disease in 3,3%, chronic diarrhea in 3,3%, and unexplained edematoascites syndrome in 1,6%. SBCE found small bowel angiodysplasia lesions in 40.6% of patients, small bowel inflammatory lesions in 15% of patients, a submucosal tumor appearance in 6.7% of patients and active small bowel bleeding in 5% patients. The examination did not objectivate small bowel lesion in 25.4% of patients. Non-small bowel lesions have been demonstrated in the form of gastric (16.9% of cases) and cecal (10.1% of cases) angiodysplasia responsible for OGIB. Conclusion: In our study, SBCE showed lesions in 74,6% of cases; dominated by angiodysplasia followed by inflammatory lesions and submucosal tumors and whose indication was essentially OGIB. Enteroscopy with biopsies or with therapeutic gesture, remains essential in the management of these patients.

The oath of medical students is in news as the National Medical Commission (NMC) proposed to replace the Hippocratic oath with the Charak oath for the students of medical colleges in India as on February 7th 2022. The NMC replaced the Medical Council of India (MCI) in September 2020 [14]. The issue got highlighted further with the students of Madurai medical college took the Charak oath instead of the Hippocratic oath in 2022 [1]. Further, in Lucknow, breaking a 110 year old tradition, the students of King George Medical University (KGMU) took Charak Shapath on the first day of 2021-22 sessions [3]. The current article sees through the oath lens & makes an effort to remind Homoeopathic fraternity to remember the Homoeopathic oath or the aphorism of the Organon of Medicine as written by Dr. Hahnemann, the founder of Homoeopathy [5]. The article assumes significance with the Times of India newspaper printing the above-mentioned aphorism as the thought for the day on 12.2.2022 in its editorial page. Further, the there is an editorial column regarding the oath below the thought for the day. The relevant page is given in the figure 1 of this article.

Objectives: To ensure the proper replacement and the continuity of effective leadership in all the management positions in the institute, effective succession planning should be implemented. The aim of the study was to assess the perception of the managers at various managerial positions regarding the succession planning implementation at their academic institution. Methods: Using a mixed research method, this descriptive, cross-sectional research was carried out at a private medical college in the eastern region of Saudi Arabia taking a convenient sample of 61 employees holding different managerial positions. An electronic, self-administered questionnaire was developed by the researchers and filled up by the participants including close-ended and some open-ended questions to assess the perception of succession planning implementation, its facilitators, and possible obstacles. Results: most of the participants revealed that the current managerial position is their first managerial position and that they had one to five years of experience. Most participants preferred to have a structural succession planning program with a mentor before moving to any future managerial position. Multitasking, followed by miscommunication were the main obstacles to succession planning. However, having previous managerial experience, and having friendly and cooperative teamwork were among the main facilitators of the managerial duties and responsibilities. Conclusion: Educational institutions generally need to develop effective succession planning for managers by designing a structural successional planning program. The greatest proportion of the participants reported that the optimal succession plan is supposed to be 4 to 6 months.

This paper focuses on the electronic conveyance (e- conveyance) under Kano Geographic Information System (KANGIS). E-conveyance is one of the blossoming concepts under the realm of Information and Communication Technology (ICT). It involves land transaction using ICT facilities. The prime object of the paper is to highlight the concept of e- conveyance under KANGIS to determine its level of compliance with the world best practices. Combinations of doctrinal and empirical methods of research are adopted for the purpose of writing the paper. It is observed that what was practiced in KANGIS is a hybrid of traditional and digital form of conveyance. It is recommended that KANGIS should try to upgrade their system of e- conveyance to conform with the world best practices.

Physical and chemical techniques have gained special interest for discovery of novel materials, nanoparticles characterization, crystals and metallic based characterization and semiconductor based materials. Nanotechnology has made tremendous advances and infinitely divisible into smaller pieces, or composed of small, indivisible and indestructible particles in the form atoms. Different approaches have used for designing of nanoparticles. Physical and chemical methods have been used for the synthesis of nanoparticles, although, some of them needed more advances for high quality and biodegradable materials to meet the industrial demands. Carbon and silica based nanoparticles can be designed in order to improve the rubber properties , while on the other hand, carbon based nanoparticles can be used for improving the polymers to increase their strength and impact resistance. Semiconductor quantum dots also made revolutionary advances for replacing the toxic materials employed. Nuclear magnetic resonance spectroscopy is the most important type of spectroscopy that helpful for industrial promotions of magnetic nanoparticles. High-performance liquid chromatography is the most important technique used in physics and chemistry in components in the given sample can be identifying easily within short period of time. Different nanoparticles can be easily accessed through Powder X-ray diffraction. One of the examples is silver nanoparticles. Crystallization is one of the most important process for solidification of atoms or molecules in such a way that they get shape the crystal.

Background: Pregnancy at extremes of age can be very challenging. The reflex of a woman to pregnancy is influenced by various factors through which woman's age at pregnancy time can be known as the single most important factor that has undeniable effect on pregnancy process and labour. Both adolescent and elderly pregnancy are considered to be high risk as they have unique outcomes. Objective: To assess the effect of maternal age on obstetric and neonatal outcome. Methods: This prospective observational study was conducted on 250 primiparous women who attended at Department of Obstetrics & Gynaecology, 300 Bed Hospital, Narayanganj, Bangladesh from March 2019-February 2020. A detailed history regarding maternal age, period of gestation, development of any signs and symptoms of various comorbidities is taken and antenatal examination is done. Routine antenatal investigations were done and all the cases were followed till delivery. Development of various maternal co-morbidities, mode of delivery and neonatal outcome was assessed. Results: Majority of our study population were in 20-34 years age group (72.0%), teenagers constituted 19.2%, advanced maternal age constituted 8.8%.The number of pre- term births in gestational age between 28 to 36 weeks were similar in teenage mothers (12.5%) and elderly primi (13.6%) where as in normal age group it was only 3.8%. Post term pregnancy where comparatively higher in elderly primi (18.8%) than teenagers (10.4%) Association of gestational age with maternal age is statistically significant (P <0.05). In our study 11% patients had Gestational Hypertension. Association of Hypertension in pregnancy with maternal age is statistically significant (p <0.05). In our study, GDM was present in 7.6%; in teenage mothers 2.1% and in elderly mothers 28.5%. In teenage 12.5% and in elderly mothers it is 31.8%. Association of Hypothyroid and maternal age is statistically significant (p<0.05). In our study anemia was seen in 4.1% of teenagers, 4.5% advanced maternal age, 3.3% in age group 20 to 34 years. In our study, 47.9% of teenage mothers delivered vaginally and 52.1% of them delivered by cesarean section. In age group 20 to 34 years, vaginal delivery was 50.2% and caesarean delivery was 49.7%. Whereas in elderly primis the rate of cesarean delivery was 71.4% and vaginal delivery was 28.5%. Association of mode of delivery with maternal age is statistically significant (p<0.05). In our study teenagers, term babies were 78.7%, pre-term babies were 12.7%, IUGR babies were 6.3% and IUD 2.1%. In advanced maternal age; term babies were 68.1%, pre- term were 13.6%, IUGR were 13.6% and IUD were 4.5%. Association of outcome of baby is statistically significant (p<0.05). In our study the babies which got admitted in NICU were 33.7% in teenage mothers and in elderly is 13.3%. Association of NICU admission among teenage and advanced maternal age is statistically significant. (p<0.05). Conclusion: Teenage pregnancy is an essential public health issue as it is associated with poor maternal and fetal outcome. Teenage and Elderly pregnancy are associated increased maternal and perinatal mortality and morbidity early detection of risk factors and prevention is necessary to reduce the morbidity.

This study empirically examines and attempt to comprehend parental communication with adolescent girls regarding reproductive health. It investigates the communication barriers from the parent's perspective. The research was undertaken in two taluks of the Ballari District, such as Sandur and Hospet. To accomplish the objectives of the study, a descriptive research design was chosen. The data was collected from 260 parents utilizing the Interview schedule and a random selection technique. The study results indicate that the average age of the parents was 33.20 years. It was discovered that the parents' age and degree of education affect reproductive health communication with adolescent girls. The association between Communicational obstacles and education has been ascertained using the Chi-square test.