Elbow dislocation may lead to disabling consequences such as elbow instability or stiffness. Complex elbow dislocation is associated with expected fracture patterns such as radial head, coronoid process, and terrible triad. On the other hand, simple dislocation is the dislocation without bony injury and is associated with a favorable prognosis. The following report describes a thirty-eight-year-old male who developed complex posterolateral elbow dislocation with irreducible trochlear fractures that blocked the reduction and mandated open reduction.

Chronic obstructive pulmonary disease (COPD) is characterised by persistent airflow limitation that is usually progressive. Additionally, exacerbations and co-existing morbidities contribute to the overall severity in the individual patient [1, 3]. Metabolic syndrome is the name for a group of risk factors that raises the risk for heart disease and other health problems such as, diabetes and stroke. It is present in almost 57% of COPD patients [2]. This is a prospective observational study included 50 patients admitted in chest ward of Sri Ramachandra hospital with Chronic Obstructive Pulmonary Disease, According to guidelines from the national heart, lung, and blood pressure (NHLBI) and the American heart association(AHA), metabolic syndrome is diagnosed, COPD staging with PFT. Each patient was included only once in the study. On admission each patients history was taken regarding occupation, smoking, medication (Inhaled corticosteroids and bronchodilators), number of years of treatment, number of acute exacerbation and number of hospital admission in last year were recorded and tabulated. Height, Weight, BMI, Pulse rate, Respiratory rate and blood pressure, ABG, lipid profile, 6minute walk test, mid arm, mid-thigh and waist circumference were recorded and sent for statistical analysis. Result showed the prevalence of metabolic syndrome in our study was 62% and was associated with severe airflow obstruction and low 6 minute walk distance. Coexisting comorbidities also more frequent in these patients.

On 13th December 1986, the famous actor of Indian cinema Mrs. Smita Patil died of child birth complications technically known as puerperal sepsis (HT, 13th Dec, 1986). 36 years later, in 2022, Dr. Archana of Dausa, Rajasthan died by suicide as she was arrested after a pregnant woman died of Post Partum Haemorrhage (PPH) in her private hospital (TNN. March 30th 2022). This clearly reflects the challenge that maternal health throws at the health fraternity. A woman’s struggle in the stage of pregnancy is full of turbulents. The struggle of mothers continues in India even today and that too in the state of UP even on a large scale. The current Maternal Mortality Ratio in India is 103 per 10000 live births & for the state of UP, it is 167 (SRS, 2019). Similarly, the Maternal Mortality Rate of India is 6.5 per 100,000 pregnant women in the age group of 15-49 years where as in UP, it is 14.7 per 100,000 pregnant women in the age group of 15-49 years. The high Maternal Mortality both in India and UP stand as a testimony to this fact as reducing this indicator is a priority. The target of achieving the SDG target of 70 per one lakh live births is a long way. The current article focuses on the initiatives of the role of homoeopathy in public health system to address maternal mortality. Basically, there are three approaches to reduce maternal mortality. These are addressing the three crucial delays related to the maternal mortality. The article focuses exclusively on these approaches while relating to homoeopathy. There are three objectives of the article. The first is to find out the current status of Homoeopathy in the maternal health practices, the second is to find out the details of the current & past implementation strategies in the homoeopathic context and the third is to find out the link between Homoeopathy & maternal health practices. The study uses secondary data. The gap that the article worked on is to explore a link between Homoeopathy & maternal health & its modalities. It deciphers whether there is a functional link currently or not & suggests future strategies based on the functionality of the link. It will be a step in the right direction to fulfill the plans to achieve the maternal health target of SDG by 2030 especially for maternal mortality related goals. For the benefit of the readers, the article includes its expected outcome, relevance to society & policy making through the context of the identified issues & the research gap. Through all these sections, the current article puts an effort to fulfill the three cited objectives of the current study related to incorporation of homoeopathy in maternal care.

Introduction: Helicobacter pylori colonization of the human gastric mucosa potentially leads to chronic gastritis that may progress to peptic ulcer disease. Additionally, this micro-organism has been identified as a risk factor for the development of gastric carcinoma and gastric lymphoma. Its relation with non-ulcer dyspepsia has not been clear. Objective: To assess the diagnostic usefulness of stool antigen test with serum Helicobacter pylori antibody and CLO test in the diagnosis of Helicobacter pylori infection in dyspeptic patients. Materials and Methods: This was a cross sectional study was conducted in the Department of Microbiology, Sylhet M.A.G. Osmani Medical College in collaboration with the Department of Gastroenterology Sylhet M.A.G. Osmani Medical College, Sylhet from July 2012 to June 2013. The calculated sample size was 196 but in this study we took 150 patients due to financial constrain and time limitation. Patients upper GI tract for dyspepsia and whoever fulfilled the inclusion and exclusion criteria were considered as study sample. All the findings, previous history and reports of investigations were recorded in a preformed data collection sheet prepared for this purpose. The patient with clinical features suggestive of dyspepsia was selected for upper GI endoscopy. Results: For this purpose, 150 dyspeptic patients fulfilling the inclusion and exclusion criteria were enrolled. The age of the patients ranged from 18 to 80 years with the mean age of 43.35 (SD ± 16.30) years. There were 32 (21.3%) patients in the age group of 21 to 30 years, 31 (20.7%) patients in the age group of 31 to 40 years, 30 (20.0%) patients in the age group of 41-50 years, 26 (17.3%) patients in the age group of 51-60 years, 21 (14.0%) patients in the age group of above 60 years and 10 (6.7%) patients in the age group up to 20 years. There were 93 (62.0%) male and 57 (38.0%) female with a ratio of male to female was 163:1. Showed the distribution of patients according to endoscopic findings. Endoscopic findings was normal in 85 (56.7%) patients, duodenal ulcer in 26 (17.3%) patients, gastritis in 23 (15.3%) patients, and gastric ulcer in 16 (10.7%) patients. The distribution of patients according to CLO test. CLO test was positive in 97 (64.7%) patients and negative in 53 (35.3%) patients. The patients according to serum Helicobacter pylori antibody by ELISA. Serum Helicobacter pylori antibody was positive in 101 (67.3%) patients and negative in 49 (32.7%) patients. Stool antigen test was positive in 73 (48.7%) patients and negative in 77 (51.3%) patients. Using CLO test as the gold standard the sensitivity and specificity of stool antigen test in the diagnosis of Helicobacter pylori infection was 72.7% and 94.3% respectively. Positive and negative predictive values were 95.9% and 64.9% respectively. The overall accuracy was 80.0%. There was moderate agreement between the two test (Kappa, k=0.603; p<0.001). Using CLO test as the gold standard in the diagnosis of Helicobacter pylori infection the sensitivity and specificity of serum Helicobacter pylori antibody was 89.7% and 82.2% respectively. Positive and negative predictive values were 86.1% and 79.6% respectively. The overall accuracy was 84.0%. There was a substantial agreement between the two test (Kappa, k=0.644; p<0.001). Conclusion: The overall accuracy was 80.0%. There was good agreement between the two test (Kappa, k=0.603). Using CLO test as the gold standard in the diagnosis of Helicobacter pylori infection this study showed that the sensitivity and specificity of serum Helicobacter pylori antibody was 89.7% and 82.2% respectively. Positive and negative predictive values were 88.7% and 100.0% respectively. The overall accuracy was 84.0%. In conclusion comparing CLO test (invasive) is still the superior to stool antigen and serology (non-invasive), both of which is going very close to each other in the diagnosis of Helicobacter pylori infection in dyspeptic patients.

Cervical ectopic is a life-threatening gynaecological emergency. It is highly prone to severe hemorrhage with maternal morbidity and mortality. It has an incidence of 1% and requires prompt diagnosis. Management is usually individualized and depends on gestational age, presentation severity and the available options and expertise. It could be medical, surgical endoscopically or a combination of treatment. A cervical ectopic in a 32-year-old nullipara who had a negative exploratory laparotomy on account of missed cervical ectopic and later a failed medical management with methotrexate. She subsequently had a dilatation and curettage under spinal anesthesia followed by medical management with repeat three doses of systemic methotrexate due to persistent haemorrhage. She was monitored with a serial level of beta human chorionic gonadotrophins until normal level was attained. Cervical ectopic is a rare form of ectopic gynaecological health workers need to have a high index of suspicion in making diagnosis and prompt intervention instituted. Though there is no standard management protocol, combination therapy of available management options has proven to be effective.

This paper is intended to review and discuss the evolution of financing instruments which are implemented on the infrastructure development projects in Bangladesh. To describe the available financing tools for infrastructure development in Bangladesh. All the instruments have divided into three sections, such as; Foreign Direct Investment (FDI), Public Private Partnership (PPP) and Islamic Finance (IF). We also discuss the acts and legislation activities related to the infrastructure as well as these three modes of financing to find out the factors needed to be assessed for suggesting the government of Bangladesh. This is qualitative research utilizing case study. The outcome of this study reveals why Shariah based financing is in fact the best and most suited way of financing the development of infrastructure in Bangladesh. Due to the regulatory constraints, many Islamic financial institutions are unable to invest their funds on infrastructure projects in Bangladesh. It is anticipated that through the outcome of this research, Shariah based financing instrument can be enhanced the infrastructure growth in Bangladesh and it will provide guidance to the potential Islamic financial institutions to contribute the funds required to develop a specific infrastructural project in Bangladesh.

Coriandrum sativum has been used in traditional medicines as an anti-inflammatory, analgesic, and antibacterial agent. It is recently been shown to have antioxidant activities. This study evaluated the effects of Flavonoid Rich Fraction of Coriandrum sativum Leaf (FRFCSL) on Lipid Profile, Nitric Oxide, Ang II and Cardio Histopathology in L-NAME intoxicated Experimental Rats. Standard analytical method and DPPH radical scavenging activity were employed for the phytochemicals and antioxidant analysis respectively. The acute toxicity study showed the extract and flavonoids fraction are nontoxic at 5000mg/kg body weight. Thirty rats were divided into five groups of six (6) rats each. Group 1 was administered water and feed only, Group 2 was administered 40mg/kg N-Nitro-L-Arginine Methyl Ester (L-NAME) without treatment, Group 3 through 5 were administered 40mg/kg N-Nitro-L-Arginine Methyl Ester (L-NAME) with concomitant administration of Captopril (20mg/kg b.w), FRFCSL (200mg/kg b.w) and FRFCSL (400mg/kg b.w) respectively for 21 days. In phytochemical screening, presence of flavonoids, saponins, tannins, alkaloids, cardiac glycosides, steroids were confirmed as part of secondary metabolites in the extract. The flavonoid fraction showed increase % DPPH radical inhibition in concentration-dependent manner. FRFCSL treatment significantly (p<0.05) and dose-dependently lowered low density lipoprotein and triglycerides. Also It significantly (p<0.05) prevented L-NAME induced decrease in serum angiotensin II, high density lipoprotein and serum nitric oxide concentrations compared to the untreated rats. The Flavonoid Rich Fraction of Coriandrum Sativum Leaf showed great potential as antihypertensive, antihyperlipidemic and cardioprotective agent in rats thus confirming its usefulness in traditional health therapy and potential for antihypertensive drug development.

The aim of our study was to understand the daily experience of adolescent girls in the Congo district who had experienced early childbearing in order to contribute to improving the sexual reproductive health of adolescent girls. This is a qualitative study approached in a phenomenological approach and it falls within the field of reproductive health. The method used for this study was the phenomenological survey and the free individual interview of 15 to 20 minutes. Our sample was 9 teenagers who had granted their availability to participate in the study. After reading our transcripts of interviews recorded with 9 respondents. Adolescent girls perceive early childbearing as an act of dishonor to family and society. Regarding the consequences of early childbearing, adolescents cited bad reputation in society, abandonment by the family and lack of support for the burden of pregnancy. In their experience as victims of early motherhood, these teenage girls used the following means to overcome difficulties: Courage and advice from people, as well as Resourcefulness and help from parents. As for the methods used by adolescents to prevent a new pregnancy, they resort to abstinence, respect for the menstrual cycle, and the use of condoms and implants. With regard to the expectation of adolescent girls who are victims of early childbearing, they seek moral and financial support from the parents and the hope of a marriage from the sexual partner.

Background: Academic stress is a significant psychological burden among adolescents and has been linked to adverse mental health outcomes. Increasing academic competition, parental expectations, and examination pressure contribute to stress levels among school-going students. Objective: To assess the level of academic stress and its association with mental health status among adolescents. Methods: A descriptive cross-sectional survey was conducted among 120 adolescents studying in selected secondary schools. Participants were selected using simple random sampling. Data were collected using a structured Academic Stress Scale and a standardized Mental Health Assessment Questionnaire. Descriptive statistics (mean, standard deviation, frequency, percentage) and inferential statistics (Pearson correlation and chi-square test) were used for analysis. Results: The findings revealed that 52% of adolescents experienced moderate academic stress, while 28% reported high stress levels. Regarding mental health status, 46% demonstrated mild psychological distress, and 22% showed moderate distress. A significant positive correlation (r = 0.62, p < 0.01) was found between academic stress and poor mental health outcomes. Conclusion: Academic stress significantly influences adolescent mental health. Early identification and implementation of stress management interventions in schools are recommended to promote psychological well-being.

Background: Cardiotocography (CTG) being a simple noninvasive tool has been used more frequently in recent decades to detect fetal distress & to reduce neonatal mortality &morbidity related to fetal hypoxia. On the other hand, umbilical cord blood gas can be used to detect fetal acidaemia due to fetal distress more accurately. This study aimed to correlate fetal monitoring findings by intrapartum CTG with umbilical cord blood pH & lactate level &test the ability of CTG to predict fetal distress & neonatal outcome. Materials and Methods: This prospective cross-sectional observational study was conducted in the Department of Obstetrics and Gynecology of Chittagong Medical College Hospital, Chattogram, Bangladesh for one year from July 2020 to June 2021. It included 80 term singleton pregnancies in active labour. Intrapartum CTG was taken and classified into normal, suspicious and pathological according to FIGO guidelines of CTG monitoring 2015. Mode of delivery, liquor colour, Apgar scores at 1 and 5 minutes, and admission to the neonatal intensive care unit (NICU), adverse neonatal outcomes were observed. Immediately after delivery of the baby 10 cm of the umbilical cord was clamped doubly and 2-3 ml of umbilical cord arterial blood was taken immediately in a pre-heparinized syringe and sent to a laboratory for assessment of pH and lactate to detect fetal acidosis. Antenatal CTG was correlated to neonatal outcomes and cord blood acidosis by statistical analysis. Results: In this study, 40.0% of the women had normal CTG, 38.8% had suspicious CTG, and 21.2% had pathological CTG. There was a significant worsening of neonatal outcomes across these three groups concerning depressed (<7) Apgar scores at 1 minute (40.6%, 80.6%, and 100%; P<0.001), depressed Apgar scores at 5 minutes (3.1%, 22.6%, and 47.1%; P<0.001), and admission to the NICU (9.4%, 38.6%, and 70.7%; P<0.001). When CTG was pathological or suspicious CTG delivery by LSCS was 5.33 times higher (RR: 5.33; 95% CI: 2.09 -13.63) compared to subjects with normal CTG. There was also a progressive worsening of cord blood pH (7.25±0.05, 7.20±0.06, and 7.13±0.09; P<0.001) and a progressive increase in lactate (3.66±1.01 mmol/l, 4.79±1.61 mmol/l, and 6.63±2.18 mmol/l; P<0.001). Conclusions: It should be concluded that pathological CTG which correlates intrapartum fetal hypoxia with cord blood acidaemia and adverse neonatal outcomes. As cardiotocography is a simple, cost-effective noninvasive tool it can be used to detect fetal distress in labour. Continues CTG monitoring can be offered or recommended in every labour room setting to detect fetal distress & early intervention to prevent neonatal morbidity & mortality.

The dynamic business environment is ingrained with high levels of competition eulogizing the need for salient functional strategies to stay afloat. Thus, the management of the manufacturing industry must formulate and implement functional strategies which would guarantee their competitiveness. However, after years of policy mending through strategic framework and government interventions the sugar factories in Kenya are still under- performing with low productivity culminating to low competitiveness and massive indebtedness within the industry. It is in this regard that the study was designed to assess the effect of functional strategies such us financial, marketing, production, human resources on competitiveness of sugar industries in western Kenya as moderated by government interventions. The study relied on institutional theory, Porters generic theory and resource-based view theories. In a bid to effectively achieve this, the study adopted a cross-sectional study design based on samples drawn from across the sugar industry in western Kenya. The study relied on all heads of departments and supervisors of all the five sugar firms which are 98 purposively selected. Data was collected by use of a questionnaire from the respondents and analyzed by use of both inferential and descriptive statistics using SPSS version 25. From the study findings correlations among the functional strategies and competitiveness were significant. With a moderator the variables jointly explained 66.6% (R2= 0.666) variation in competitiveness of sugar industry with a significant F change at ρ<.05. In conclusion government intervention significantly influences the relationship between functional strategies and competitiveness of sugar industry. The management of sugar industry should formulate and implement functional strategies in line with government interventions to effectively enhance their competitiveness.

A current paradox in the Vietnamese labor market is that there is lack of workers with enough knowledge and skills to meet the needs of the job, but an abundance of those who cannot. The reason for this situation is that in the process of training and education, universities have focused a lot on equipping learners with knowledge, the formation and development of professional skills are often given less attention. Therefore, post-trained human resources entering the labor market still lack the necessary skills in the labor process. Meanwhile, firms in Vietnam are well aware of the great role of workers' working skills, which is an important factor in the current period, especially skills to adapt to the 4th industrial revolution. Therefore, in the process of educating, training and fostering human resources in school, higher education institutions need to consider supplementing and equipping learners with necessary skills to create products. The school’s output can best meet the needs of recruitment and jobs in the labor market in the current new period.

The centrality of exchange rate in stock market performance cannot be over-emphasized. Thus, this study examined the dynamic effects of exchange rate on market capitalization in Nigeria. The specific objectives are to examine the effects of nominal exchange rate, real effective exchange rate, real interest rate and inflation rate on market capitalization using time series data which were obtained from the WDI and World Federation Exchanges Database between 1993 and 2020. Unit root test, cointegration test, ARDL estimation method, Granger causality tests were applied to analyze the data. The unit root test results showed that only market capitalization is stationary at levels whereas the other variables become stationary at first difference. The bounds cointegration test result revealed that market capitalization has long run relationship with the explanatory variables. The results revealed that real effective exchange rate impacted positively on the market capitalization. This implies that increase in real exchange rate (depreciation of the naira) creates opportunity for increase in the capital market size. The results further revealed that nominal exchange rate has an insignificant positive effect on market capitalization in the short run and long run. This could be linked to the inconsistency that characterizes the official exchange rate policy in Nigeria. It was also found that real interest rate has significant negative effect on market capitalization in the long run. At the same time, inflation rate negatively affected market capitalization. The Granger causality test results showed that a unidirectional causality runs from real interest rate and market capitalization. Given the findings, this study recommends that policymakers should ensure that the exchange rate management prioritizes a realistic and stable exchange rate to boost global competitiveness and improve market capitalization.

Background: Coronary artery disease is a known entity of morbidity and mortality in industrialised countries. It is a major public health problem around the world. Coronary artery disease increase incidence in Indian population at least 10 years before in age than other ethnic groups. There are a numbers of factors associated with atherosclerosis the most important one is dyslipidemia. Recent studies suggest that over the span of 20 years, the total amount of triglycerides, cholesterol and Low Density Lipoproteins (LDL) `levels is usually increased in young urban populations. So, a study was performed out to know the prevalence of dyslipidemia in urban North Indians among different set of age groups. Methods: This is a descriptive cross-sectional study which was carried out on patients visiting to the blood collection centre of the Department of Pathology. Patients were divided into 3 groups with age 18 year to 40 year, 41 year to 60 year and >60 year by involving 1989 subjects of whom 532 were between 18 year to 40 year, 522 were between 41year to 60 year and 935 were > 60 year of age. This study included measurement of fasting serum lipid profile comprising of, Low Density Lipoprotein (LDL), High Density Lipoproteins (HDL), Triglycerides and total cholesterol. Results: Number of subjects studied, the prevalence of dyslipidemia was higher in <60 years age population. A remarkable difference in mean was observed statistically with the levels of triglycerides, LDL and total cholesterol of this age group ranging from 18- 40 years and for those who are >60 years. A remarkable difference for the levels of HDL was not found in age group between 18 – 40 years and > 40 years to 60 years. Mean cholesterol level was observed to be elevated between the age group 18 – 40 years. The mean peak triglycerides were observed in age group between 41-60 years. This elevated mean HDL levels were noticed in the age group who are > 60 years of age. Conclusions: Elevated percentage of dyslipidemia was observed in less than 60yrs age groups. Large population study is required to substantiate the results of this study. It is necessary to plan out comprehensive strategies for the screening and awareness in all ages on periodic basis.

Introduction: Nonfermenting gram-negative bacilli (NFGNB) are a taxonomically diverse group of aerobic, nonsporing, bacilli that either do not utilize glucose as a source of energy or utilize it oxidatively. They occur as saprophytes in the environment and some are also found as commensals in the human gut. In recent year NFGNB have emerged as important health care associated pathogens. They have been incriminated in infections such as bacteremia, meningitis, pneumonia, urinary tract infections, surgical site infections, wound infections, osteomyelitis etc. Materials and method: During Nine Month study period, various samples were collected aseptically and transported immediately to the bacteriology laboratory. The pathogens were identified by standard laboratory procedures including Gram’s staining, motility, culture, colony characters and biochemical reactions. Antimicrobial susceptibility testing was performed by modified Kirby Bauer method as per the CLSI guidelines using Muller-Hinton agar and available antibiotic disks. Result: A total number of 312 NFGNB were isolated from 4112 clinical samples. Most frequently isolates NFGNB were Pseudomonas aeruginosa (42.62%) and Acinetobacter spp. (25.32%). NFGNB isolates were more common in males (58.33%) as compared to females (41.67%). Maximum sensitivity was seen to Polymyxin B (100%), Meropenem (83.45) in Pseudomonas aeruginosa and Meropenem (78.48%), Pipracillin-tazobactum (62.02%) in Acinetobacter spp. Conclusion: NFGNB are emerging as important pathogens and shows resistance to commonly used antibiotics. Minimized use of available antimicrobial, regular use antimicrobial susceptibility surveillance and strict infection control measures are required to control this emerging antimicrobial resistance among NFGNB.