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.

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.

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.

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.

Successful entrepreneurial start-ups follow somewhat similar pathways towards an entrepreneurial/corporate development and eventually an exit, where investors as well as founders are handsomely rewarded for their contribution by investors who purchase the company or float it in an Initial Public Offering at the financial markets. In this paper, we will explore and combine three different pathways for entrepreneurial companies towards corporation growth: 12 steps in value creation and corporate development, 6 steps in financing and 4 stages in knowledge creation. An attempt is made to combine and simplify the existing models with the purpose of identifying entrepreneurial barriers to growth and suggesting solutions. Furthermore, these models are tested and validated by so called “deep” qualitative interviews of 6 Kuwaiti entrepreneurs who are operating their own startups in Kuwait. The result is a Kuwaiti model for entrepreneurial pathways, pinpointing barriers to growth and ways out of the “Valley of Death” towards rapid corporate growth and entrepreneurial succession.

Background: ALL is a malignancy of B or T lymphoblasts which is characterized by unrestrained spread of abnormal, immature lymphocytes and their progenitors which results in the replacement of bone marrow and other lymphoid organs subsequently. Methods: This study was a observational cross sectional study conducted at the Department of Hematology, in Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh. The study period was from October 2019- September 2020. The sample size for this study was 100. Result: Most of the respondents 53(53%) were from <20 years and the mean age was 30±11.18. The female was 68(68%) and male was 32(32%). Fever was found in 100% cases and Progressive pallor in 98%. Bony tenderness was found in 58 cases and followed by Splenomegaly 48, Lymphadenopathy in 46, Oral ulcer in 46, Hepatomegaly in 36. The range of Total WBC count (x109/L) was (6-435) and the Mean±SD was 52.51±78.70 and followed by Hb% (gm/dl) was (4.1-13.4) and 9.25±1.49, Platelet (x109/L) was (5-20000) and 505.20±2815.29. S. uric acid (mg/dL) was (1.40-30.03) and 5.76±4.61. S. inorganic phosphate (mg/dL) was (2.30-7.70) and 4.19±1.20. S. potassium (mmol/L) (2.50-5.40) and 3.92±0.56. S. calcium (mg/dL) was (1.10-11.80) and 8.33±2.08. S. creatinine (mg/dL) was (0.19-3.59) and 89±0.55. In 72% TLS was absent and in 28% was present. Conclusions: Rapid spread of TLS often causes severe toxic effects on organs, which leads to renal impairment, epilepsy, cardiac arrhythmias, pulmonary edema, and even death.

The teaching of physical education teaching is different from other disciplines, sports teaching is not simply to make the students master a few sports action, but to put the knowledge and skills learned in the course become amateur exercise ability, exercise consciously to do outside, so almost all physical education teachers need to undertake to the student interest in sport, but the present school education, Many students are never interested in physical education. This paper adopts the method of literature and logical reasoning to explore this phenomenon, and holds that the reasons for this phenomenon are as follows: 1. Negative life and entertainment, 2. Students under pressure to meet the examination standards, 3. Monotonous teaching content and form. In order to solve these problems and improve the interest in physical education, we need to carry out reasonable teaching design, adopt a variety of teaching means and methods, and pay attention to the classroom and students themselves.

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.

The alarming spread of novel corona virus, severe acute respiratory syndrome corona virus 2 (SARS-CoV-2), has resulted to an ongoing pandemic of corona virus disease since 2019. Due to this the virus is popularly known as Covid 19 virus. The world has not been able to get rid of this disease and we are into the fourth wave. There have been numerous changes in the nature of the disease but it is still causing major disruptions all over the world. Tobacco use as smoking is a major cause of mortality as well as morbidity around the world. Nobody can dispute the ill effects of smoking on health. Surprisingly, there have been few reports about low incidence of smokers among Covid 19 patients. This article aims to review available literature on the subject and try to clear the misconceptions on this topic.

Thyroid benign (TBN) and malignant (TMN) nodules are a common thyroid lesion. The differentiation of TMN often remains a clinical challenge and further improvements of TMN diagnostic accuracy are warranted. The aim of present study was to evaluate possibilities of using differences in chemical elements (ChEs) contents in nodular tissue for diagnosis of thyroid malignancy. Contents of ChEs such as calcium (Ca), chlorine (Cl), iodine (I), potassium (K), magnesium (Mg), manganese (Mn), and sodium (Na) were prospectively evaluated in “normal” thyroid (NT) of 105 individuals as well as in nodular tissue of thyroids with TBN (79 patients) and to TMN (41 patients). Measurements were performed using non-destructive instrumental neutron activation analysis. It was observed that in TMN tissue the mean mass fraction of I was lower while the mean mass fractions of K and Mg were higher than in NT and TBN tissue. It was demonstrated that I content is nodular tissue is the most informative parameter for the diagnosis of thyroid malignancy. It was found that “Sensitivity”, “Specificity” and “Accuracy” of TMN identification using the I level in the needle biopsy of affected thyroid tissue was significantly higher than that using US examination and cytological test of fine needle aspiration biopsy. It was concluded that determination of the I level in a needle biopsy of TNs using non-destructive instrumental analytical method is a fast, reliable, and very informative diagnostic tool that can be successfully used as an additional test of thyroid malignancy identification.

Introduction: Non-communicable disease causes over 36 million deaths globally each year. And among the NCD deaths, over 82% of premature deaths occur in underdeveloped and developing countries. Some of the non-communicable diseases like hypertension, diabetes and asthma are emerging as major health problems in Bangladesh. The Bangladesh government has given high priority to research these particular diseases. But although there are many global studies regarding the risk factors of hypertension, not much research has been done regarding the increasing risk of hypertension in rural areas. This study aims to determine the correlation of various factors with hypertension among the population of a rural locality. Methods: This was a cross-sectional study conducted in the rural area of Dumki upazilla of Patuakhali district. Sample population was selected following simple random sampling technique. Socio-demographic information, information about smoking, family history of hypertension status were collected using a pre-prepared questionnaire. Blood pressure, body weight and height of 255 individuals between the age range of 40-90 years of both sexes were measured and collected. Result: Among the participants, 98 were male and 157 were female. The mean age of the participants was 45.28 years, and mean weight was 56.27 kg. 40% of the participants were aged between 41-50 years and 38.04% were aged between 51-60 years. Among the participants, majority were educated, and only 16.47% were illiterate. Majority of the participants (39.61%) were housewives, and 10.98% were service holders. Only 7.45% of the participants were unemployed. The biggest risk factor in the present study participants was excessive salt intake, present in 64.84% of the participants. This was closely followed by family history of hypertension, present in 61.18% of the participants. High BMI was also present in 48.63% of the participants. Conclusion: Increased BMI and high blood pressure are high risk factors for hypertension. Hypertension was observed to occur more in the female population, and the risk of hypertension increased with age. Excessive salt intake and smoking, Jarda consumption and tobacco chewing are also some risk factors observed in this particular rural study.

Introduction: Nurses has responsibility in prevention and control of infection in hospitals. Hand hygiene practices, a way to prevent of infection in hospital, but so many factors can influence adherence of hand hygiene practices. Attitude may influence of adherence of hand hygiene practices. Aim: Aim of study was to measure of attitude and hand hygiene behavior among of the nurses. Methods: This study used an observational analytic with study of cross-sectional method. Aim research were to study of relationship between attitude and adherence hand hygiene practice among nurses In-patient Unit District Hospital Semarang. Number of samples were 107 nurses on duty at In-patient Unit of the District Hospital Semarang. The data collected by filling a questionnaire of attitude and observation of hand hygiene practices. The data of demography, level of attitude and level of adherence hand hygiene described by distribution of frequencies analysis, and Spearman Rank Test used to analyze a relationship between attitude and adherence of hand hygiene practice. Results: Attitude of nurses to hand hygiene showed 75,7% positive, and compliance level to hand hygiene practice were showed 63,6%. Relationship analysis between attitude and adherence of hand hygiene practice among nurses done by correlate analyzed with Spearman Rank Test. The results of bivariate analysis r2 0.269 indicated correlated between attitude and adherence hand hygiene, probability result p=0.005 (<0,05) indicated significant relationship between attitudes and adherence of hand hygiene practice among nurses acquired by Spearman Rank Test. Discussion: Attitude may influence adherence of the hand hygiene practice among nurses. Confirmed analysis that good attitude, may increase of adherence of hand hygiene practices. To improving adherence hand hygiene, not only influence by attitude, also influence by rule and procedure and must be same perception about importantly of hand hygiene practice can be prevented of cross infection in hospital.