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.

This research investigated and described the experiences and ways of coping among low- income parents of La Paz, San Narciso, Zambales, Philippines during COVID-19 pandemic. The COVID-19 pandemic has primarily affected Filipino families most particularly the low-income earners. Income loss for affected individuals is assumed to start at the beginning of the crisis and lasts the duration of the crisis. Most of the respondents receive wage which are spent for their children’s basic needs. They are not financially capable of providing gadgets for their child/children as well as continuous internet connection. Majority of parents are not permanently employed for they are probably on-call, seasonal workers, small scale entrepreneur, self-employed and/or farmer. Parents encountered and experienced delayed payments of their medical expenses and monthly utility bills. Some participants were laid off from their jobs/works and with this condition they barely avail of essential services. In reality, the crisis might exacerbate savings depletion at the onset due to the delay in assistance. Parent participants cope with the adverse economic effect of the COVID-19 pandemic by venturing on other form/mode of earning income like online selling, farming and fishing.

This study aims to evaluate the strength and performance of retrofitted anchorage system in concrete under impact loads. A novel technique called “Post Installation of Supplementary Anchorage” (PISA) is introduced to retrofit five different configurations of rebar anchorage system used in concrete. The configurations of rebar are straight bar (A1), 90 degree bend (A2),180 degree hook (A3), single head (A4) and double head (A5) bars which was retrofitted by supplementary steel reinforcement. Direct tension pullout loads are applied on 60 anchorage specimens (each 30 of conventional and retrofitted) casted with M25 grade concrete. The boundaries of tested specimens were followed by strut-and-tie analogy. The rebar anchorage tested at 1.58, 1.52 impact factor using two different bars of 12mm and 16mm diameter respectively. The deterministic characteristics of test parameters are normal strength, bond strength, ductility, and slip of anchorage at ultimate load. The test variables are rebar configuration, size of anchored bar, and presence of supplementary steel. The results validated by nonlinear finite element based ANSYS modeling. A good agreement of results between experiment and model analysis was observed. Also a considerable improvement of nonlinear characteristics of retrofitted anchorage such as ultimate load (3%-6%), bond strength (1%-6%), ductility (3%-4%), concrete contribution (20%-32%), bar slip (8%-48%) and crack width (30%-42%) was obtained. This study promotes useful information to retrofit non-engineered anchorage system by PISA technique. Application of this technique may further extended to retrofit discrete regions of concrete elements such as bracket connection, corbel projection and beam-column joint subjected to impact loads.

Background: Stroke is currently the second leading cause of death worldwide and the first leading cause of death in Bangladesh. The National Institute of Health Stroke Scale is the most commonly used deficit rating scale to assess stroke severity. S-100 protein is a low molecular weight calcium-binding protein expressed mostly in glial cells like astrocytes, oligodendrocytes, and microglial cells. During the ischaemic process, S-100 protein is secreted from the glial cells into the extracellular space. After secretion, S-100 protein releases initially into the cerebrospinal fluid and then eventually into the bloodstream due to disruption of the blood-brain barrier. Aim of the study: To correlate serum S-100 protein level with the severity of ischaemic stroke. Methods: This cross-sectional study was conducted at the Department of Laboratory Medicine in collaboration with the Department of Neurology, BSMMU, Dhaka, Bangladesh from September 2018 to August 2019. A total of 70 ischaemic stroke patients were enrolled in this study. After taking proper history and neurological examination, the severity of ischemic stroke was assessed on the basis of NIHSS score. Then, serum S-100 protein levels were measured by the Electrochemiluminescence Immunoassay method. Statistical analysis was done by SPSS version 22.0. Results: According to the NIHSS scores, 35(50.0%) of the patients had moderate stroke (NIHSS score=5-15), 17(24.3%) had minor stroke (NIHSS=1-4), 12(17.1%) had moderate to severe stroke (NIHSS=16-20) and 4(5.0%) had severe stroke (NIHSS=21-42). The mean S-100 protein level was found 0.283±0.165 μg/L. Mean S-100 protein levels was assessed in different categories of severity of ischaemic stroke. Maximum Mean± SD value of serum S-100 protein was found in case of severe stroke (NIHSS score=21-42; Mean ± SD: 0.739±0.207, range: 0.523-1.019). The significance test was done by ANOVA test which was found statistically significant (p-value <0.001). Pearson’s correlation test revealed a significant strong positive correlation (r=+943, p<0.001) between serum S-100 protein level and NIHSS scores of ischaemic stroke patients. Conclusion: In the present study it was found that serum S-100 protein levels were higher in severe ischaemic stroke in relation to the ischaemic stroke of lower severity. S-100 protein level is rapidly determined by the method used in the present study. Serum S-100 protein level in this regard can be used as an important tool to predict the severity of ischaemic stroke. Further study is needed to confirm the findings of the present study.

This study was carried out to examine the use of verb tenses in the writings of senior secondary school students, learners of English as a foreign language in Niger. Three hundred and seventy (370) students randomly selected from four (4) senior secondary schools in Maradi participated in the study. The data were collected using an essay test requiring the students to express their thoughts in the present, the past, and the future tenses. The study used mixed methods research. The results showed that the students’ use of verb tenses in English was very inappropriate. Furthermore, the results revealed that all the three tenses were found difficult by the students leading to verb tense errors of various types including substitutions, additions, and omissions of morphemes. Some recommendations were made to help the students use verb tenses appropriately, and minimize errors in verb tense use.

The antioxidant potential of crude ethanolic as well as ethyl acetate and n-hexane soluble fractions of Jatropha tanjorensis which is widely used in indigenous system of medicinal for different purposes were studied. The antioxidant potential of extract different Fractions were evaluated using different in vitro antioxidant models which includes Ascorbic acid, Beta carotene, flavoniods, total phenols, ABTS, H202, FRAP and reducing power. The estimation of the crude extract showed ascorbic acid (93.51mg/kg), beta carotene (10.564mg/kg), flavoniods (7.88mg/kg), total phenols (64.03mg/kg), ABTS (64.21%), H2O2 (6.39%), FRAP (0.221µmol/ml) and Reducing power (2.913µmol/ml). That of ethyl acetate fraction and n-hexane fractions for Ascorbic acid, beta carotene, flavoniods, Total phenols, ABTS, H202, FRAP and reducing power are as; 227.8mg/kg, 9.21mg/kg, 0.59mg/kg, 33.94mg/kg, 96.47%, 2.5%, 1.1911 µmol/ml, 4.500µmol/ml and 228.7mg/kg, 9.21mg/kg, 0.59mg/kg, 33.94mg/kg, 98.93%, 2.32%, 1.578µmol/ml, 4.456µmol/ml respectively. However, the result of this Study reveals the plant contains some appreciable amount of the antioxidant models analyzed which is vital to illnesses associated with oxidative stress thereby revealing that the plant is a good source of natural antioxidant.

Dermatomyositis is a type of inflammatory myopathy characterized by inflammatory and degenerative changes of the muscles and skin. The paraneoplastic dermatomyositis is a subtype associated with cancer. The pathophysiothogy remains unfully understood. The diagnosis is supported by both the clinical and serological features. The treatment involves both the DM and the malignancy. Multi-disciplinary management is fundamental for patients. However the pronosis remains usually poor. We report a case of paraneoplastic dermatomyositis revealing an ovarian cancer, the purpose is to illustrate the diagnostic, therapeutic and pronostic of this entity.

Many skin lesions have been reported in connection with tattoos, both benign and malignant. The pathogenesis of malignant transformation in tattoos is unknown, although hypotheses include the toxic effects of the pigments. To date, we have notice 31 case reports and series (17 men, median age: 50.5 years) of KA and CSC on tattoos. Other factors; UV exposure, fair skin, and immunosuppression increase incidence of cSCC. Recurrence and metastasis are associated with tumor diameter greater than 2 cm, depth greater than 2 mm or beyond subcutaneous fat, extensive or large-caliber perineural involvement, and poor differentiation on histopathology. AJCC 8 is used for TNM staging for cSCC of the head and neck. BWH offers an alternative T staging system. Management is primarily surgical with rare indications for adjuvant chemoradiation.

Background: Caesarean section rate has been on the increase in the past few years. Previous caesarean sections are a major indication for caesarean sections. The risks associated with repeat caesarean sections have brought about the need to adopt vaginal birth after caesarean section (VBAC) as the preferred mode of delivery in a previously scarred uterus. Aims and Objectives: To determine the pregnancy outcome and complications of vaginal birth after caesarean section at the University of Port Harcourt Teaching Hospital. Materials and Methods: This was a retrospective descriptive study of 121 women with one previous caesarean section who presented at the labour ward of the University of Port Harcourt Teaching Hospital between January 1, 2010, and December 31, 2019. Data was obtained from the case notes, ward, and theatre registers, encoded into a spreadsheet, and analyzed using SPSS 22.0. The results are presented as means, rates and proportions. Associations between variables were assessed using students t-test and Pearson’s correlation. Statistical significance was considered at P<0.05. Results: There were 20,661 deliveries during the period under review. Of these, 175 had vaginal birth after caesarean section (VBAC). However, only 121 case notes were available for analysis. About one third, 44 (36.36%) of the women had previous successful VBAC and 5 (4.13%) had augmentation of labour. Perineal laceration was the most common complication 38 (31.4%). Majority of the babies 103 (85%) had APGAR scores > 7 in the first minute, while 10 (8.55%) were admitted in the Special Care Baby Unit. Maternal age, socioeconomic status, gestational age at delivery and birth weight were not significantly associated with the outcome of VBAC. Conclusion: Vaginal Birth after Caesarean Section is safe and should be recommended in carefully selected women with previous caesarean section, to reduce the morbidities associated with repeat caesarean sections.

Background: There are many types of arthritis, but osteoarthritis (OA) is one of the most frequent. IA injections of corticosteroids into the knee joint may improve pain and impairment by relieving joint inflammation. Purpose: To evaluate the effectiveness and safety of hylastan, a novel viscosupplements, with a single intra-articular corticosteroid injection in the treatment of knee osteoarthritis pain (OA). Because of its large molecular weight, the sodium hyaluronate in Hylastan is more likely to stay in the joint for an extended period of time than other viscosupplements. Methods: Multicentered based randomized quasi-experimental comparative study was performed in Shah Mokhdum Medical College, Rajshahi, Bangladesh, from January 2019 to December 2021. Enrolled patients aged ≥40 years. Patients were randomized 1:1:1 to one of three arms: 2 X 4 mL hylastan (n = 129; arthrocentesis then IA hylastan Day 0, same treatment Week 2); 1 X 4 mL hylastan (n = 130; arthrocentesis then IA hylastan Day 0, arthrocentesis only Week 2); steroid (n = 132; arthrocentesis then IA methylprednisolone acetate 40 mg Day 0, arthrocentesis only Week 2). The primary clinical outcome measure was changed from baseline in WOMAC A pain score overall postbaseline visits to Week 26. Results: Statistically significant pain reduction was observed in all three arms, with similar mean (95 % CI) changes in WOMAC A: 2 X 4 mL hylastan -0.9 (-1.0, -0.7); 1 X 4 mL hylastan -0.8 (-0.9, -0.7); steroid -0.9 (-1.0, -0.8); all p < 0.0001 versus baseline. Changes in secondary outcomes were similar in all three arms. Target knee adverse events were comparable for all treatments. Conclusions: An acceptable safety profile and effective pain relief were found with both IA hylastan injection regimens. The hypothesis of better pain relief with IA hylastan was not met compared to IA corticosteroid. The effectiveness and safety of hylastan compared to other viscosupplements require more investigation. Level of evidence Therapeutic study, Level I.

Date palm tree (Phoenix dactylifera L.) is an important crop or khajoor in the local language which is cultivated in many countries. Different types of dates are present but Ajwa khajoor is very beneficial in cardiovascular activity, heart disease, antimicrobial, nephroprotective, antioxidant, anti-inflammatory activity, provide relaxation during pregnancy, reduce risk of tooth decay, improve bone health, and also provide mental clarity. Prophet Muhammad (Peace Be upon Him) said that the best assets are date palm, dates cure several disorders, and he suggested Muslims to eat the date and have a tendency the date palm. Dates play key role in anti-cancer activity, anti-tumor, cardio-protective activity, and neuroprotective activity. Dates fruits and seeds are considered essential nutrients and medicines. They can be used in a variety of cosmetic and beauty products. Many cosmetic products contain high levels of chemical compounds, commonly found in synthetics such as hydroquinone. Date seed oil has been shown to have a positive effect on human skin and hair, as well as a few products (body creams, soaps, hair products, and sunscreens) are sold. Seed oils have high oxidative properties, extended storage capacity, and can protect the skin from UV rays and repair it. Bioactive compounds, such as flavonoids and phenolics, can prevent hair loss and promote hair growth. The extracts from dietary seeds are rich in phytosterols, essential fatty acids, and nutrients needed to maintain healthy scalp, promote normal hair growth, and support nourishing functions of sebaceous glands and hair follicles. It is important to all synthetic skincare products and medically very beneficial.

Background and aim: Inflammation has been long regarded as a key contributor to atherosclerosis. Recent decades have provided extensive and mounting evidence concerning the pivotal interplay between inflammation and CAD, reinforcing the concept of inflammation not only as a risk marker but also as a risk factor for the development and progression of atherosclerotic disease. Methods: This was a case control study that has been enrolled among 404 patients, divided into two different groups (case-CAD patients and control group-Patients with Normal Coronary Angiography) that presented to Catheterization unit of Surgical Specialty Hospital- Cardiac Center/ Erbil City-Iraq from 1 Sept 2021 to 1 Jan 2022. Results: A total of 404 patients of case and control group was included from both genders, the mean age was 55.9 ±10.6, ranging from 30 to 77 years of age, based on their coronary angiographic profile 57.4% of them were Coronary Artery Disease cases and 42.6% were controls. (58.4%) of the study population were males and (41.6%) were females. The mean of CRP level amongst cases were higher (6.2 ± 10) than the controls (3.5 ± 4.7), and this was significant with a P = 0.022. In our study we found that Highly Sensitive-CRP was high amongst Case Group (Patients with CAD) by 70% while comparing to only 30% of Control group who had High CRP levels. And this was statistically significant with a P value of 0.003. Conclusion: The level of CRP was higher among patients with Coronary Artery Disease, than those with Normal Coronary Angiography. The level was higher among.