As digit ratio (2D:4D) factor corresponds with high level of performances, fine-tune skills and immense ability were evidently found, but however the impact of 2D:4D on aerobic and anaerobic fitness components among younger subjects has yet to be fully understood. Thus, the main objective of this study is to examine the role of 2D:4D towards performance in physical fitness tests comprising of both aerobic-based and anaerobic-based elements. Results were collected from six physical fitness tests involving 594 primary schoolchildren (aged 10 to 12 years old) of both genders. Fingers images were taken through hand scanning method and the ratios were measured and calculated. Priorly, effect of covariances (age and body mass index) was found to have no effect on the fitness tests. For male students, the low 2D:4D of both hands showed various significant relationship with non-anaerobic based tests acquiring lower R2 below 10%. Both genders reported to have higher percentage of variability of dependant variables detected at anaerobic based tests with the highest was found at standing broad jump test. Meanwhile, for the female subjects mixed results were found with all aerobic based tests scored lower R2 below 10%. Overall, low digit ratio was much prominent in anaerobic-based tests in both male and female subjects. This study suggests that 2D:4D thrives more in anaerobic based events/tests among younger subjects and with thorough research, it is possible to implement 2D:4D as additional instrument in identifying sports talents and categorizing potential athletes according to the related fitness components.

This study develops a competency model for the HR Department of PT TCO and measures the competence of incumbents to determine employee competency profiles to identify competency gaps. The designing process of the competency model used the Behavioral Event Interview (BEI) technique to find out the critical of each job description. Competency measurement is carried out using behavioral indicators that have been compiled in the competency model. The rating scale method using a multi-rater was chosen to measure incumbents' competence. From the formulation of the competency model, four (4) core competencies, fifty-three (53) behavioral competencies, and 130 technical competencies were obtained. The competency level standards can apply to anyone holding the relevant position if the job description does not change. In addition, it is also obtained an overview of the same job cluster; different levels of positions tend to have the same competency model but different levels of competency standards. The results of the preparation of the competency model above; the company is recommended to implement the same process in other departments or divisions so that a comprehensive competency model can be arranged for all positions in PT TCO. The company is also expected to constantly update job descriptions linked to the entire series of competency models and explicitly carry out core competencies, especially by top management, so that they can be seen by all employees, even at the grassroots level.

On the basis of synthesizing and analyzing the opinions and knowledge of experts, selecting the fitness assessment tests for male athletes of the Vovinam youth team of Ho Chi Minh City aged 16 - 17. Through the research, 10 tests have been identified to assess the physical condition of male athletes of the Vovinam youth team of Ho Chi Minh City age 16 - 17. Initial test results show that the physical strength of Vovinam male athletes is similar with no dispersion.

Severe cholangitis is an urgent indication for endoscopic treatment, represented by endoscopic retrograde pancreatography (ERCP) and endoscopic sphincterotomy. It ensures good bile drainage, and improves patient morbidity and mortality. Materials and methods: This is a retrospective study carried out within our department between January 2010 and April 2018. All patients with severe cholangitis who benefited from therapeutic ERCP were enrolled. We analyzed the epidemiological data of the patients, the results of the ERCP, as well as the post-sphincterotomy mortality. We also performed multivariate analysis for predictive factors for mortality. Results: 88 patients were enrolled. The average age of the patients was 60.14 years [17-102 years], with a female predominance (n = 45, 51.1%). Twelve patients (13.6%) underwent a cholecystectomy. Almost 68, 18% patients (n = 60) had obstructive choledocholithiasis, fifteen patients (17,04%) had o cyst hydatic and 13 patients (14,77%) had tumor obstruction. Successful catheterization of the main bile duct was reported in 60 patients (68.18%), and failure in 28 cases (31.81%). The use of precut was performed in 28 cases (31.81%), which enabled successful access to main bile duct in 24 patients (85.71%). Failure of catheterization after a precut concerned 4 patients (14.28%): 3 patients (75%) benefited from a resumption of ERCP with success, and only one patient (25%) was proposed for surgery. fifty-five patients (91,66%) underwent stone evacuation (Figure 1). For 5 patients (8, 33%), failure of stone extraction was followed by successful surgery. Twenty-one patients benefited from successful implementation of a biliary prosthesis were objectified in 21 patients (25%). 5 patients (23.80%) failed. Among them, percutaneous drainage was done 4 patients (80%) and 1 patient (20%) was operated. The main post-ERCP complications were represented by: 5 cases (5.7%) of papillary bleeding, and 1 case of acute pancreatitis. The overall death rate was 11,36% (n=10). The course was marked by clinical and biological remission in the other patients with successful endoscopic drainage. The main predictors of mortality in multivariate analysis were impaired of consciousness upon admission (p = 0.023, OR=4, 5678 [2,678‑10, 7890]), and the presence of renal failure (p = 0.001, OR=6, 4809 [2,089‑15,781]). Conclusion: Endoscopic treatment is the gold standard for the treatment of severe cholangitis. Its results are satisfactory, with a lower mortality compared to surgical treatment with fewer hospitalizations.

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.