Introduction: Breech is the commonest mal-presentation where increased perinatal and maternal mortality and morbidity are reported compared to cephalic presentation. This unwanted outcome can only be prevented by planned delivery methods. The aim of the study was to compare fetal outcomes in all delivery methods among the primiparous and multiparous women and thereby helping in preparing appropriate delivery protocol in breech presentation. Methods: This prospective study was done at the Department of Obstetrics & Gynecology of Rangpur Medical College with a total of 104 pregnancies. Appropriate cases of breech presentation were included and all necessary information was noted including predictive factors, management details, and outcome of the delivery. Result: Among the 104 participants of the study, 53 were primiparous pregnancy, and 51 were multiparous pregnancy cases. In total, 28 out of 104 had vaginal deliveries, and 76 had a delivery through cesarean section. The cesarean section had a much higher prevalence (81.13%) among primipara cases. 22 of the primipara and 20 of the multipara cases had planned for vaginal delivery, but successful vaginal delivery was observed to be 22.7% in primiparous women and 45% among multiparous women. The mean age was 24.58 years among the primiparous women and 28.9 years among the multiparous. A higher percentage of multiparous cases (80.4%) had no fetal complications compared to primiparous cases (71.7%). Among neonatal complications, birth traumas were significantly more frequent in the primiparous compared with multiparous. 43.4% of neonates needed admission from the primipara group compared with 33.3% in multipara. Among maternal complications, a higher percentage of multipara women suffered from different morbidities compared to primiparous, which was statistically significant as a whole. Conclusion: Proper planning of delivery methods is important to decrease both maternal and fetal morbidities and mortality irrespective of parity. Primiparous mothers with breech presentation are more prone to undergo cesarean deliveries and thereby develop postoperative complications. But multiparous mothers have more complications during the delivery process. Overall neonatal complications especially birth traumas are more common among the babies of primiparous mothers.

The Research Paper ‘Application of the Strict Liability Rule in Rylands v Fletcher to Oil Spills in Nigeria’, is a robust and timely evaluation of the legal concept of Strict Liability as it applies to the recurrent problem of oil spillage in Nigeria. For several decades now, crude oil production sites have regularly spilled oil and other petroleum-related chemicals, into the riverine communities of the Niger-Delta region of Nigeria. This has sometimes devastated the fishing and farming livelihoods of the poor villages within the vicinity of such spillages, and agricultural productivity is greatly reduced. This is in addition to air pollution, wildlife decline and overall environmental degradation. This paper looks at efforts to hold accountable those responsible for such degradation using the concept of Strict Liability. In order to obtain justice and compensation for the riverine communities, it must be proven that the offending oil companies were guilty of nuisance and negligence, as described by the Rule in Rylands v Fletcher. The companies are expected to know that their activities are reasonably likely to cause far-reaching destruction to the environment. Concluding, the paper makes recommendations to further tackle the problem of oil spillage in Nigeria.

Background: Partograph is a simple, of low cost but most important tool for record of progress of labour In the developing country like ours, where both pregnancy and maternal mortality rate is so high, the use of this inexpensive partograph is essential. Objective: To assess the importance of partographic control of labour in preventing prolongs labour and its consequences, thereby decreasing maternal morbidity and mortality and improvement of neonatal outcome. Method: This study was done in the Obstetrics and Gynaecology department of Institute of Child and Mother Health, Matuail, Dhaka. Total 196 patients were included in this study. Data were collected by predesigned data collection sheet. Data were analyzed by using Statistical Package for Social Science (SPSS) version 14. Result: 74% of these patients had spontaneous vaginal delivery, 7.14% required assisted delivery (forceps or ventouse) and 18.9% needed caesarean section. Caesarean section was done in 18.9% patients because of fetal distress (32.4%) and prolonged labour (67.6%) due to malrotation and cephalopelvic disproportion. Patients with non-engaged head in labour required more intervention than who had engaged head. With the use of partograph, unnecessary interventions were reduced. It was found that 66.7% of the patients were delivered within 7 hours and all patients were delivered within 10 hours from active phase of labour. Thus prolonged labour and its consequences, such as obstructed labour and ruptured uterus, can be avoided by using partograph. In 100% of the patients, crossing the action line in partograph required interference, but 92.5% within alert line of partograph delivered vaginally spontaneously and 7.5% required assisted delivery (forceps or ventouse). When IDR was 1 cm/hr 85.1% women delivered spontaneously. When IDR was <0.4 cm/hr, 100% of patients required some kind of interference. Thus, the maintenance of partograph in labour enables the obstetricians to recognize very early dystocic labour and act accordingly. Conclusion: With the help of a partogram, time of delivery can be estimated and if the progress is slow, an appropriate interference at the right time can be instituted before the labour becomes dangerously protracted. IDR very helpful in making early decisions about the prognosis for the type of labour. With the use of partogram and its scientific application, the result showed that operative interventions were reduced, duration of labour was within normal limit and there was no obstructed labour and no maternal or perinatal mortality.

This study validates the relevance of Lean strategy in Nigerian pharmaceutical companies in Anambra State. Specifically, the study ascertained the effect of lean manufacturing approach on efficiency of pharmaceutical companies in Anambra State and determine the effect of lean manufacturing approach on competitiveness of pharmaceutical companies in Anambra State. The study adapted a descriptive survey research design since the study is to distribute questionnaires to the respondents. The population of the study consists of 80 staff of 6 selected pharmaceutical companies in Anambra State. Data were collected through the questionnaires administered to respondents. T-test statistical tool was used to test the two hypotheses with the aid of SPSS version 20. 0 at 5% level of significance. The study revealed that lean manufacturing approach has effect on operational efficiency of Pharmaceutical Companies in Anambra State. Findings of the study provided support that lean contributed in integrated value chain supply and competitiveness in manufacturing companies. Therefore, the study concluded that lean manufacturing approach has effect on efficiency and competitiveness of pharmaceutical companies in Anambra State. Based on the findings, the study recommended that manufacturing companies should strive to adopt lean thinking approaches, principles and practices so as to reduce inherent variations with suppliers and demand from customers for greater effectiveness of the company.

Background: Abortion is defined as the loss or termination of a pregnancy before 20 weeks of gestation or when the fetus weighs less than 500 g. Induced abortion is defined as the use of medications or surgical intervention to stop pregnancy after implantation but before the embryo or fetus has become independently viable. The purposeful termination of a pregnancy, known as induced abortion, is one of the most common gynecological treatments. In this study, attempts have been made to show the clinical presentation, management, and outcome of patients. Aim of the study: The study aimed to assess the outcome of a patient after induced abortion. Methods: It was a prospective observational study. The study was conducted at the Department of obstetrics and gynecology, Dhaka Medical College Hospital, Dhaka, Bangladesh during May-Oct'2007 from all induced abortion cases admitted in different maternity units, 80 cases are randomly selected for the study. Proper ethical consent was taken from the concerns. All necessary investigation was done, and necessary pieces of information were noted in a preformed data collection sheet. Finally, the results were analyzed and presented in different tables using a computer and the SPSS database. Result: In this study, it has been seen that around 45.5% of gynecology patients are of abortion, and the incidence of induced abortion was 16% among all gynecological admission. The majority of abortion cases (58.75%.) were conducted by untrained persons. Among the patients, 8.75% had adequate knowledge about MR, while 51.25% had unreliable or incorrect information regarding MR. 55% of cases had used contraceptives. A total of 76.25% of patients got admission within 1 month of their complications. Among all cases, 92.5% were improved while the death rate was 7.5%. Amongst 23 specimens of high vaginal swab culture 15 (65.22%) patients showed growth of Escherichia coli, 3 (13.5%) of staphylococcus, 3 (13.5%) of pseudomonas, 1 (4.34%) of protus, 1 (4.34%) of klebsiella. Conclusion: All this can be reduced by improving socioeconomic condition, educational status, popularizing family planning, and modernization of existing laws in relation to abortion.

Introduction: Dichlorvos (DDVP), an active ingredient of Sniper insecticide, is commonly used in Nigeria to control insects by killing them thereby preventing the spread of diseases. However, it can be highly toxic to humans when inhaled into the respiratory system which could elicit oxidative stress and cause respiratory infections. Vitamin C is known to be an anti-oxidant, capable of inhibiting oxidative stress. This study was aimed at investigating the ameliorating effect of vitamin C on dichlorvos-induced toxicity of the rat lung. Materials and methods: Forty (40) male wistar rats (weighing 150 – 200g) were recruited and randomly grouped into five (5) groups of eight (8) rats each. A group was the control; two groups were exposed to graded concentrations of DDVP while the last two groups were treated with vitamin C. Body weights were obtained before and after the period of 21-day exposure. After 21 days, histopathological and biochemical analysis were carried out to examine the level of toxicity of DDVP and effect of vitamin C treatment on the lung tissues. Results: Rat groups treated using vitamin C administration had significant improvements in body weights compared to DDVP-exposed groups. MDA levels as well as CATA and SOD activities increased significantly on vitamin C-treated rat groups (p < 0.05). Post treatment of rat groups with vitamin C showed that the lung histoarchitecture significantly improved. Conclusion: It can be concluded that Vitamin C could be a supplementary remedy in organophosphate (dichlorvos) poisoning through inhalation.

Anti-neoplastic drugs are known to have teratogenic effects on the fetus. In this case report we are presenting a case of a patient who got operated for breast carcinoma, conceived while on chemotherapy and underwent termination of pregnancy in the second trimester. Fetal haemorrhage and ecchymosis lead to further evaluation of the case, which revealed fetal thrombocytopenia, a rare teratogenic effect of the anti-neoplastic drugs.

Background: Using an evidence-based guideline for obstetric risk assessment in the primary and secondary healthcare settings in Nigeria has been shown to aid appropriate referral cascade of patients to tertiary centres. Aim: To assess the impact of inappropriate obstetric risk assessment and late referral to tertiary care facilities in Rivers State on perinatal morbidity and mortality. Material and methods: The study was of prospective cross-sectional design involving 475 patients who were referred from primary and secondary healthcare facilities to the labour ward of Rivers State University Teaching Hospital in Nigeria. The appropriateness of their obstetric risk assessment and referral cascade to a tertiary centre was assessed, using a preformed evidence-based guideline and the results were associated with the perinatal morbidity and mortality. Data were analysed using Epi Info 2020. Results: The perinatal outcome in women that needed to be referred in the first trimester to tertiary centres was worse than that in those women who were appropriately referred and the differences were statistically significant in terms of birthweight less than 2500 grams [170(54.66%) versus 8(24.24%), X2 = 9872 p<0.002]; birth asphyxia [78(19.02%) versus 0(0%), X2 =7.926 p<0.0003]; admission to SCBU [85(20.73%) v 0(0)%); X2=8.916 p<0.0001] and foetal death [77 (18.78%) v 0(0%); X2=7.787 p<0.0003r]. The differences were also worse in terms of the number of patients who had preterm birth at 28-37 weeks, FGR and large for date (LFD) babies but the differences were not statistically significant. Furthermore, the perinatal outcome in women that needed to be referred in the first trimester to tertiary centres was also worse than that in those who needed an earlier referral to tertiary centres and the differences were statistically significant in terms of birth asphyxia (X2=2.341, p<9.045); admission to SCBU (X2=2.699, p<0.055) and foetal death (X2=2.291, p<0.047). The differences were also worse in terms of the number of patients who had preterm births, neonatal birth weight, LFD babies and FGR but not statistically significant. Conclusion: Perinatal morbidity and mortality were worse in patients who needed to be referred to a tertiary centre from a primary and secondary healthcare facilities than in those who were appropriately referred and those that needed an earlier referral. There is therefore an urgent need for adoption of evidence-based guideline for obstetric risk assessment and referral cascade in Nigeria.

The research aimed at describing the legal protection concept geographical indication in supporting the economic right of geographical indication holders, the contribution of geographical indication in improving the prosperity of geographical indication holders, and the legal protection of the economic rights of geographical indication about the use of a sign that is similar to a registered geographical indication. This research encompasses the normative legal analysis and empirical research methods. The first problem statement used the normative legal research method, which analyses how the legal protection concept of geographical indication supports the economic rights of geographical indication holders. The empirical research method was used for the second problem statement, which analyses how registered geographical indication contributed to improving the prosperity of geographical indication holders and was also used for the third problem, which analyses the legal protection of the economic rights of geographical indication holders about the use of a sign that is similar a registered geographical indication. The research results indicate the following: (1) the legal protection concept of geographical indication that is integrated into the law of trademark and geographical indication has not supported the economic rights of geographical indication holders, either from the substance aspect or with regards to the stipulated legal sanction; (2) the economic rights of geographical indication holder relation to production monopoly right, sign use, and product marketing has not contributed to the improvement of their prosperity; (3) the legal protection of the economic rights of geographical indication holders about the use of a sign that is similar to a registered geographical indication is still weak, both in the private and public legal enforcement aspects.

General anesthesia (GA) is one of the pharmacological modalities used in the treatment of pediatric dental patients. This study aims to assess the rate and associated factors of repeated dental rehabilitation under general anesthesia in pediatric patients; The electronic health records of three- to 12-year-old children who received dental treatment under GA between 2015 and 2019 were identified and analyzed. Subjects were classified into cases with repeated dental treatment under GA within 5 years and controls who had dental GA once. Each case was matched to three controls based on gender and age. The collected data included the child's age at the first and second dental GA, gender, health status, Type, and the number of dental treatments provided. A total of 2376 patients had dental treatment under GA. Forty-five controls were matched to 15 cases in a 3:1 ratio. The prevalence of repeated dental GA over 5 years was 0.63%. The number of restorations, pulp therapies, and extractions showed no statically significant differences except for the number of crowns, which was higher in controls compared to cases (p=0.011). Treatment of patients under GA requires a more aggressive course of treatments compared to local anesthesia. Consequently, it is advisable to choose full-coverage crowns rather than composite or amalgam restorations.

Formalin is the most widely used preservative in anatomical embalming. It produces consistent results in terms of the prevention of autolysis and putrefaction at an affordable cost. It is a known carcinogen having several health hazards. Strict adherence to safety protocols is required to minimize its toxic effects. Regular monitoring of formaldehyde concentration in the dissection hall and embalming room will ensure remedial measures at the earliest. In the face of growing health concerns, several alternative preservatives are being studied. Apart from it, methods like cryopreservation, plastination can be used instead of embalming. Post-mortem toxicological analysis of formalin-fixed cadavers is of importance for forensic investigation. This article will review the overall advantages and disadvantages of formalin and its alternatives in the process of embalming and will guide the anatomists in choosing the proper options for the purpose.

Background: Laparoscopic management of hydatid cyst in the liver is now becoming popular with the introduction of modern devices like Pallanivelue Hydatid Cyst Cannula System that makes the procedure easier, safe, and acceptable. The laparoscopic approach is not only a cosmetic issue; it also prevents the recurrence rate by preventing spillage and complete removal of endocyst. Objective: Here we assess the Laparoscopic management of hydatid cyst in the liver of 30 cases at the Department of General Surgery. Methods: It is a prospective study having ages ranging from 18 to 65 years were included in this study, from April 2015 to March 2020. Laparoscopic endocystectomy was performed in all cases with deroofing of the cyst wall and observed the outcome of the procedure. All the cases were diagnosed clinically and confirmed by ultrasonography and CT scan. Results: A total of 30 patients, 13 males, and 17 were females. The most common presenting complaints were pain in the abdomen in 20(66.66 %), a lump in the right upper abdomen in 18(60 %), jaundice 2(10 %). Hepatic Hydatid cyst diagnosed by USG, CT scan, and serological test were included in this study. The distribution of cyst sizes was: 1-5 cm 3; 6-10 cm 8; 11-15 cm 10; > 15 cm 9 patients. Abdominal ultrasound and CT scan were done to confirm the diagnosis of hepatic hydatid cyst in all patients. The right lobe was involved in 25(83.33 %), left lobe in 4(13.33 %) with both lobes in 1(3.33 %). Intraoperative complications 5(16.66%). Per operative bleeding 1(3.33%), spillage 2(6.66%), and cystic biliary communication 2(6.66%). The main operating time was 95(60-120) minutes. The mean duration of hospital stay was 5.22(3-10) days. Conclusion: The laparoscopic cyst evacuation and omentoplasty using PHS are safe for treating the hydatid cyst of the liver in the selected patients, while addressing all the conventional surgical principles of treating the hydatid cysts, like aspiration, prevention of spillage, sterilization of cysts, and partial deroofing. It aids early recovery with good cosmetic results. PHS is an ideal method for single or multiple hydatid cysts of the liver with minimal complications and morbidity.

Chancroid is a sexually transmitted disease (STD) caused by the Gram-negative bacterium Haemophilus ducreyi and is characterised by necrotising genito-perineal ulcers which may be accompanied by inguinal lymphadenitis or bubo formation with possible spread to the thigh. We presented a rare case of a 23year old polytechnic undergraduate who presented to the hospital with complaints of extensive painful ulcer in her vulva for over ten (10) days. On culture of the swab from the ulcer, Haemophilus Ducreyi and E Coli sensitive to Ceftriazone, Ofloxacin and Gentamycin were isolated. Patient was treated with IV Ceftriazone for 5 days and Ciprofloxacin for 10 days with good recovery. The case highlighted the need for increased vigilance in managing genital ulcers in contemporary clinical practices and for carefulness in the choice of a sexual partner and practices among adolescents and young girls.

Activated Carbons (ACs) were prepared from jute stick charcoal by chemical activation using H2SO4 and H3PO4 ranging temperature from 3000C to 3500. The activated carbons and charcoal prepared from jute sticks were characterized by evaluating the surface chemistry, structural features and surface morphology. The properties of the carbons were characterized by Scanning Electron Microscope (SEM), Brunauer – Emmett-Teller (BET), X-Ray Diffraction (XRD) and the FT-IR method. The jute sticks were converted to activated carbons with the highest surface area (135–245m2/g) and largest mesopores volume (0.14–0.16 cm3/g). The FT-IR spectra exhibited that the pyrolysis of jute stick resulted in the release of aliphatic and O - containing functional groups by thermal effect. However, the release of functional groups is effect of chemical reaction in the ZnCl2, H3PO4, and H2SO4 activation process. A honeycomb carbon structure in activated carbon was formed as observed on SEM images. Although charcoal and activated carbon were prepared at 3000C to 3500, the activated carbon exhibited much lower Raman sensitivity due to the formation of condensed aromatic ring systems. Due to high surface area and high porous structure with abundance of functional groups, the activated carbon prepared from jute sticks charcoal absorbed molecules with much higher than those of other activated carbon.

Commercial Papers (SBK) or often referred to as Commercial Paper (CP) are securities that are classified as promissory notes and appear in practice as an alternative to corporate funding. In 1995 Bank Indonesia issued Bank Indonesia Decree No: 28/52/KEP/DIR and Bank Indonesia Circular No: 28/49/UPG concerning Requirements for Issuance and Trading of Commercial Paper through Bank Indonesia. Then in 2017 Bank Indonesia revoked the decree and again issued Bank Indonesia Regulation (PBI) No: 19/9/PBI/2017 concerning the Issuance and Transaction of Commercial Securities in the Money Market. This study seeks to examine matters related to SBK or CP after the issuance of PBI NO: 19/9/PBI/2017, especially the problem of formal requirements for SBK as securities; the parties involved and their legal responsibilities in the SBK or CP transaction. This research is a normative legal research with a descriptive type that is sourced from legal materials, both primary, secondary and tertiary legal materials and analyzed qualitatively. The results of this study indicate that the formal requirements for SBK follow the provisions of the formal promissory note as stipulated in Article 174 and Article 175 of the KUHD. PBI No: 19/9/PBI/2017 does not stipulate other formal requirements, but stipulates the criteria for SBK (CP) to be issued for transactions through the Money Market. The parties involved are issuers, issuance support institutions, Bank Indonesia, transaction actors and transaction support institutions, administration and settlement of SBK transactions. Each of these parties has a legal responsibility, namely the issuer has legal responsibility in terms of payment of Commercial Securities issued. The issuance support institutions have legal responsibilities in protecting consumers (investors) while transaction actors, transaction support institutions, administration, and transaction settlements have the responsibility to create a credible SBK or CP market and trade.