Background: PCOS is a leading cause of infertility globally. Polycystic ovarian syndrome (PCOS) is a complicated disease pigeon-holed by high testosterone levels, irregular menstruation, and/or tiny cysts on one or both ovaries. The disease can be anatomical (polycystic ovaries) or biochemical (hyperandrogenemia). Follicular developmental inhibition, ovarian microcysts, anovulation, and menstrual irregularities are all symptoms of hyperandrogenism, a clinical characteristic of PCOS. Objective: The objective is to determine the chances of infertility in a patient presenting with PCOS in childbearing age. Methodology: Data was collected from Medline, PubMed, ScienceDirect, and the Obsgyne online library for papers published between 2005 and 2021 using specified MeSH keywords in this systematic review. We examined 10 cross-sectional type analytical studies for data collecting in this systematic work. Results: 10 studies conducted between the years 2005 to 2021 were included in this systematic review. There were 3900 women in the study, ranging in age from 10 to 40. The 2nd most prevalent etiology of feminine factor-related infertility was determined to be PCOS in this investigation. In 70% of cases of anovulatory infertility, PCOS is the reason. As a result, it's critical to screen for and treat it in primary care settings. Ultrasound is the best modality for the detection of PCOS. PCOS has been identified using ultrasonography methods in several investigations. The basal follicle counts by TVS might be included among sonographic findings in the diagnosis of PCOS, with basal follicle counts of more than 10 is a PCOS criterion. Slightly swollen stroma, hypertrophy, enhanced ovarian mass and thickness, and the percentage of ovarian stroma to total ovary area are among the other characteristics. Conclusion: From this systematic review we concluded that infertility is most commonly caused by PCOS. In 70% of cases of anovulatory infertility, PCOS is the reason. Despite the fact that TVS is the gold standard for detecting ovarian abnormalities in young girls we examine trans-abdominally by using a high-frequency probe. Ultrasonography results for PCOS of the periphery cyst patterns include a considerable variety of small subcapsular follicles (10 follicles with a maximal diameter of 8 millimeter), enhanced ovarian volume (12.3 millimeter), and increased echo density of the ovarian stroma.

Background: Imaging plays a key role in the diagnostic evaluation of women for infertility. The pelvic causes of female infertility are varied and range from tubal and peritubal abnormalities to uterine, cervical, and ovarian disorders.

A basalt-based automobile brake pad was developed through optimization of the volume fractions and manufacturing parameters, a mathematical model was developed based on rule of mixture for the optimization of the volume fraction and the solution obtained using excel solver is as follow; basalt 38%, cast iron chips 26%, bronze 12%, glass fibre 12% and phenolic resin 12%. The manufacturing parameters were design using full factorial design of three levels and three factors, twenty-seven runs were obtained from the design, consequently twenty-seven samples were produced by compression moulding. The constituent materials were properly mixed to obtained homogeneous mixture and compressed into a mould with a cavity similar to the shape of the friction pad this was done at different moulding pressures of 30MPa, 27MPa and 24MPa, the curing temperatures were 1800C, 2000C and 2200C and the curing of 5minutes, 10minutes and 15 minutes as obtained from the factorial design. The samples produced were subjected to tests, the results showed that the basalt brake pad has the following properties; compressive strength of 137mPa, coefficient of friction 0.476, hardness 70HRB, density of 2768kg/m3 thermal conductivity of 0.66W/mK, water absorption of 0.377%, oil absorption of 0.25%, void content of 18.93%, wear rate of 9.0X10 -4g/m and the TGA result shows that the basalt-based brake pad is thermally stable up to a temperature of 5000C. The properties of the basalt-based brake pad are within the acceptable range and can satisfactorily substitute basalt.

Quality assurance and Quantity aftermaths are binary terms, which are interconnected each other closely and its ramification often chaotic in the fast pace world, specifically construction industry. Moreover, it’s being used an inappropriate way as a substitute one for other. Quality over quantity, It’s a simple concept, which could be understand in layman term but taught to construction organization because quality is a process per se, whereas quantity is a form of amount. However it' can be defined in one line that fits like a square peg in a round hole in today's construction/corporate environment. The reason behind that it's so inflexible to emphasize quality over quantity is simple, contemporary businesses are established merely to make money as quickly as possible and its highest possible margins. Crafting high quality components tends to be expensive and time consuming tasks, moreover it required industriousness along with proper management, which seems less attractive margin for the organization and create a question in the mind what about the profit. Lower quality work, produced quickly with a minimal time commitment per task, tends to be far more profitable, with higher margins as well as a lower cost and get more attractive price from consumers. However, corporate shouldn’t entirely overlook the importance of quality over quantity. Here it’s not merely a matter of profit although it’s a matter of lives, which matters more than anything else. Moreover, the elements of a building structure are typically based on the kind of material used in its construction. Each and every division has space in a design takes into account the main theme or concept of the structure. Depending upon the building material(s), each element of the building is related to the other in terms of the concepts of color, dressing and outlook. The materials used for an element also, quite often, contribute to its terminology. Quality take off is widely unaccepted as one of the key factors for companies to be futile in the global market. Quality management has been a kicked issue for many years in various disciplines. The implementation of effective quality management has been witnessed and documented in the Engineering industry, which set up a paradigm for other disciplines such as the design and construction industry in the past few years, things have been changed in the construction sector by welcoming Policies that would improve construction process and lead to successful business strategies. Effective quality management, especially in (QOQ), It has been recognized as an inhibitor for performance improvement in the construction industry. On the flip side Quantity takeoffs are an important aspect of the construction cost estimating process. Quantity takeoffs are used in both large and small projects to determine actual costs ensure that a project remains profitable to the contractor, and its vital component of a final detailed estimate. General contractors, subcontractors, quantity surveyors, and estimators routinely produce quantity takeoffs during the estimation process. Whereas some in the construction industry may not routinely work on quantity takeoffs, they may still wonder what a quantity takeoff in construction is. We’ll also look at the different ways qualities as well as quantity takeoffs are completed, and what are the advantages and drawbacks of these different methods. The study recommends that promoting awareness regarding the values of ethical behavior at different forum and ensuring the effective castigation for unethical activities at different stages of project life cycle might reduce the unethical practices in the construction industry. Nevertheless both terms has to be targeted as per its vitality, as we have used the word of interconnected.

Immunity in insects is the series of events by discretion of signal proteins as a part of memory cells. The most important role of defensive proteins and peptides in insects are against function, assigning immune responses distinctly to priming and basal. But insects are also a source of high quality protein, containing many essential amino acids required for human nutrition. One their host enters into the cells of targeting area, immediate onset of proteolytic cascades that causes the cleavage of protein molecules of the attacking organisms. Immune system of the insects enhances exhibit properties the of production of antibodies and phagocytic cells to clear microbes and damaged cells from an organism. The most different types of immunological responses arise as pathogens enter into the cells of insects and activate the machinery of metabolic pools. The main reason for genetic and biochemical evaluation lie behinds the diversity of natural ecosystem of insects. Sterile insect technique has been controlled for direct killing. It is used primarily to control or eradicate insect pests, usually crop pests or human and animal. Integrated pest management, the broad-based approach that integrates practices for economic control of pests that significantly improved the yields of agricultural crops.

Combretum micranthum (CM) is well known for its ethno-medicinal uses in the northwest of Nigeria with little or no scientific basis. Thus, the aim of this research is to evaluate the methanol leaf extract fractions of Combretum micranthum for possible antioxidant compounds. The results of DPPH free radical scavenging showed that ethyl acetate fraction has a higher radical scavenging activity then followed by aqueous fraction of 87.913±3.927 and 84.718±0.605 respectively, compared with ascorbic acid reference standard 80.351±0.732 at 2500ug/m1 concentration. In FRAP, the result showed that ethyl acetate has a higher antioxidant property of 0.818±0.035 followed by aqueous which is 0.800± 0.002 compared to ascorbic acid which is 0.426±0.000. The LC-MS profile revealed the presences of several compounds as follows: 3,4,5-trihydroxy-6-(3-hydroxy-2-(2-hydroxypropan-2-yl)-7-oxo- 2H, 3H, 7H- furo (3,2-g) chromen -9-yl)oxy)oxane-2-carboxylic acid and (5- (1E) -3- (6- (3,4- dihydroxy -2,5- bis (hydroxymethyl) oxolan -2-yl) oxy) -3,4,5- trihydroxyoxan -2-yl) methoxy) -3- oxoprop -1- en -1- yl) -2-hydroxyphenyl) oxidane sulfonic acid in ethyl acetate fraction and Atavaquone, Fenarimol, 12-tricosanol, Myricetin, Histidylasparagine and Homocycteine thiolactone in aqueous fraction. The result of the docking revealed some potential and antioxidant activities of the fractions with significant binding interactions between compounds and alpha amylase & alpha glucosidase. Therefore based on the compounds identified by LCMS analysis coupled to the in-vitro antioxidant studies it can be concluded that these fractions of Combretum micranthum can be used against free radicals and potential in drug management.

Background: currently the Elderly population is rapidly increasing and with this increment comes more challenges for the healthcare system, non-adherence to medications especially in elderly can lead to economic and human lost that is avoidable by improving patients' compliance and address the related issues leading to the non-adherence. Objectives: 1-assess the level of adherence knowledge and belief to medications. 2-identify the related factors causing the non-adherence. Methodology: A cross sectional study was conducted in primary healthcare centers in Baghdad targeting geriatric age group of both genders attending the primary healthcare centers and having at least one diagnosed chronic disease, the study enrolled10 healthcare centers from both sides of Baghdad. Patients were directly interviewed and data was collected using a questionnaire. Results: The study showed that (83.4%) of the sample (n=385) had low adherence level, this percentage tend to increase as the age increases, no significant association was found with gender variable, and a significant association was found with the age variable. most of the participants has low beliefs level (86%) and only (7%) of the sample scored (high) on knowledge level which was significantly associated with adherence level, (13.5%)of the participants faced high difficulty to adhere to their medication. Conclusions: Elderly patients attending the primary healthcare centers in Baghdad had low level of adherence; most of them did not have enough knowledge about their medications. Patients who scored low level of adherence tend to pay more visits to the healthcare centers.

This review sums up the current information in regards to anatomy, biomechanics, clinical presentation, differential findings, Imaging, physiotherapy treatment, pre-operative and post-operative recovery of athletic pubalgia. The athletic pubalgia is more common in male athletes as compare with female athletes. Most usually, men experience the ill effects of athletic pubalgia that expects athletes to perform sharps turns, cutting, turning and tedious kicking. The debilitating of posterior inguinal wall is the offender behind athletic pubalgia. It is caused by immoderate and disproportionate application of shear forces through the normal attachments of the abdominal muscles and hip adductors. At present there is no unanimity of assessment on the constituents of this analysis. Since, it is not difficult to characterize a reasonable finding that depends on actual assessment, the techniques, for example, symptomatic ultrasonography and MRI are regularly utilized essentially to offset the presence of different conditions. This is high an ideal opportunity for committed research work on outcome estimation of chronic athletes and furthermore putting together its prosperity totally with respect to reasonable for getting back to sports action. Furthermore, it is likewise needed to have point by point depictions of the techniques, surgical anatomy, conventional treatment and recovery. The data acquired from such an research work will help in understanding pathogenesis of athletic pubalgia in a superior manner, develop proof arranged screening and check for better surgical techniques and successfully oversee both post-surgical and conservative recovery.

Background: Müllerian agenesis is a disorder of genital development characterized by absence of the vagina, an absent or hypoplastic uterus, and normal or hypoplastic fallopian tubes. Typically, the ovaries are entirely normal, although one or both also may be undescended, hypoplastic, or associated with an inguinal hernia. Affected patients often also have urologic anomalies (15-40) % (unilateral renal agenesis, ectopic or horseshoe kidney, and duplication of the collecting systems) and skeletal malformations (5-10) %, (e.g., hemiverterbrae and scoliosis, or the Klippel-Feil syndrome). The cause is unknown, although some cases are associated with chromosomal translocations or occur in familial aggregates, suggesting a genetic basis. Logically, müllerian agenesis might be attributed to an activating mutation in the gene encoding AMH or its receptor, causing excess AMH activity, but none have been identified. Aim: The aim of this study was to analyze and present rare cases of partial mullerian agenesis combined with renal and/or skeletal malformations, their causes, clinical features, diagnosis and treatment along with review of literatures. Methods: A retrospective observational study was conducted in the department of Bangabandhu Sheikh Mujib Medical University. All four cases presented with similar type of presentation and were diagnosed as partial Mullerian aplasia (cervico-vaginal agenesis) with other associated anomalies (renal, skeletal or cardiac anomalies) ie: MURCS association. Results: We analysed four cases of mullerian agenesis with renal and/or skeletal abnormalities presented with primary amenorrhoea with cyclical lower abdominal pain. Subsequently these patients were ascertained to have cervicovaginal agenesis with renal and skeletal abnormalities by physical examination and relevant investigations. Two (50%) patients had renal anomalies in the form of renal agenesis and one small malrotated kidney while 100% patients had skeletal abnormalities. One (25%) patient had congenital cardiac anomaly, one (25%) patient had history of cleft lip and cleft palate and one (25%) patient had history of imperforated anus at birth. Evaluation included clinical examination, whole abdominal ultrasound, skeletal survey and karyotyping along with some supportive investigations. Conclusion: The management is varied but multidisciplinary approach, psychological and social supports are the key points of managing such cases.

Tobacco consumption takes away millions of lives worldwide each year. Several approaches have been adopted to curb this tobacco pandemic. Motivational Interviewing (MI) is a technique that amalgamates several theories of behavior change and models of psychotherapy to overcome the ambivalence of these tobacco users, to motivate them to quit the habit. This article bestows an overview of MI, its principles, core skills, and essential strategies, explicating its application for tobacco cessation.

In the context of building an ethical enforcement system for general election organizers in Indonesia, apart from the need to complete and reinforce the material for legislation, it is also important to question the effectiveness of the work of general election organizers. The organizers of the General Election have the authority to impose sanctions on perpetrators of violations of the General Election administration. The emergence of ethical enforcement problems for the organizers of the General Election, especially in Article 458 paragraph (13) and paragraph (14) of Law no. 7 of 2017 concerning General Elections, which explains that the DKPP's decision is final and binding, this can lead to legal uncertainty and cannot be equated with final and binding decisions from judicial institutions in general because DKPP is an internal election organizer that is authorized by law. The results of this study have theoretical implications, especially concerning the code of ethics in the administration of elections that has developed so far which views that laws and regulations apply as the only absolute recognized standard of truth. This study has practical implications, that state law needs to be adapted to the conditions and situations of this nation, not to the interests of certain parties. Enforcement of ethics as described in Law no. 7 of 2017 concerning General Elections. The substances regulated are obligations to the state, obligations to the community, integrity, independence, and professionalism of the General Election Organizer. Although there is no explicit mention of the obligation to honor a code of ethics that is implemented properly/not violated is expected to place the General Election Organizer in the highest honor.

Background: education program plays a major role in teaching, enhancing, and improving nurses' knowledge and practice regarding bowel stoma care. Aim: To study the effectiveness of education program on nurses' performance regarding bowel stoma care at the governmental hospitals in Khartoum state. Methods: A quasi-experimental hospital base study was conducted in three governmental hospitals; fifty nurses were chosen by using Probability Proportional to Size (PPS) sampling technique. Data were collected using checklist for practice assessment in three phases. Data were analyzed using Statistical Packages for Social Sciences (Version 23) presented in tables and figures using descriptive percentages, means and stander deviation, chi sure test used for relation significance and T-test used to show the difference between pre and post means. Results: shows that mean of total practice score changed from poor to good .and there was a highly significant difference at p ˂ .001 between pre- and post-implementing education program. Conclusion: On light of the study results it can be concluded that there was a highly significant improvement in practice items between pre and post education program, and the study recommended that there should be an in-service training and periodic educational programs targeting nurses to improve nurse’s knowledge and practices.

Objective: The objective was to evaluate the efficacy of MI varnish in preventing white spot lesions in patients with fixed orthodontic therapy. Method The study was performed where 100 patients undergoing orthodontics treatment were allocated randomly to 2 subgroups with differing frequencies of MI varnish application. Degree of mineralisation was measured on the vestibular surfaces of 12 teeth (6 varnish & 6 unvarnished controls) Measurement were taken at 4 sites using camera EOS 750D and then subjected to statistical analysis. Results: The statistical analysis showed difference in the degree of demineralization between treated and untreated teeth, and was statistically significant in terms of time point, frequency of application or specific tooth site. Conclusion: Periodic application of MI varnish can offer some protection against white spot lesions and it is not statistically significant degree if patients have excellent oral hygiene. Additional protection is conferred by applying the product every 3 months compared with every 6 months

It is reasonable within the range from 45 ° to 90 °. It shows that it is maximum of the efficient resolved tensile and shear stress at 90°. The twin is the most active around 45 ° roughly the most active range is 22.5 to 67.5°. Therefore we believe that the possibility of twin is relatively high. The effective stress according to s2eff=ss2+tc2-2sstc cos (90°+ϕ) and the adapted effective stress s2eff=ss2+tc2 likely excludes a little deviation with 0~4MPa in Ti2AlNb. The deviation is largest with 4MPa in ϕ of 42.5° in Ti2AlNb. The range rate is 0.5%. According to efficient stress & twins and dislocation happen at λ=45°and 90°.

This study entails the research data of the empirical study carried out on the compressive strength determination of Granite dust-Sandcrete with granite dust as partial replacement of three (3) grades of river sand with fineness modulus (fm) of 2.29, 2.44 and 2.89. The percentage replacements range from 0%, 10%, 20%, 30%, 40%, 50% to 100%. A gross number of 102 cubes of 150 × 150 × 150mm square metallic mould were blend, mixed and cast with a mix ratio of 1:5. Three (3) cubes were blend, mixed and cast for each percentage partial replacement and a total 34 cubes for each grade of river sand, were crushed to derive the compression strength of 28th day curing respectively. For river sand with fineness modulus of 2.29, the highest strength was recorded on 80% replacement, while the least strength was recorded on 0% replacement. For the same river sand, compressive strength increased from 0% to 80% and assumed a descending trend from 80% to 100%. For 2.44 fineness modulus, the highest strength was recorded on 80% replacement, while the least strength was recorded on 0% replacement. Also, for the same river sand, compressive strength increased from 0% to 80% and assumed a descending trend from 80% to 100%. For river sand of 2.89 fineness modulus, the highest strength was recorded on 70% replacement, while the least strength was recorded on 0% replacement. Also, compressive strength increased from 0% to 70% and assumed a descending trend from 70% to 100%. Generally, the compressive strength assumed an upward trend as the percentage replacement increases.