Biomedical waste (BMW) is generated mainly by health care establishments. The management of BMW is still infant all across the world. According to Biomedical waste management rule 2016 (amended in 2018),the health facilities need to ensure proper segregation of BMW and pre-treat the waste at the facility before disposal/handing over the equivalent to Common Bio Medical Waste Treatment Facility (CBMWTF). A detailed study on BMW status in few of the Primary Health Centres (PHC) of Guwahati was carried out. The study depicts that only 30 % of the facilities does have nodal person to monitor the BMW activities. None of the facility having coloured plastic bin/bags with biohazard symbol, designated waste route, weighing machine and centralized storage area. Collection of BMW by the CBMWTF was average twice a month.

Background: Polycystic Ovarian Syndrome (PCO), also called Hyper androgenic anovulation (HA), or Stein-Leventhal syndrome is a very common disorder of ovaries that only occurs in females mainly of reproductive age of 4% to 20% approximately. It is a condition in which multiple cysts, almost 9 to 10 are noted in the ovary, can be on one side or both sides and the volume of the ovary exceeds 10ml. The common representation of PCOS includes obesity, acne, hirsutism, and complications in pregnancy. Objective: To evaluate among the largest population which age group is the most having polycystic ovarian syndrome. Methodology: A literature search was performed with the use of search engines. The search engines that provided the articles for systemic review are Google Scholar, MDPI, PubMed, Medscape, and NCBI. For article searching following keywords were used: Polycystic ovaries, reproductive age changes, and age group. Conclusion: It is concluded that there is a specific age that has Polycystic syndrome ranging from 12-25.

Objective: The purpose of this study is to decide the prevalence of primary and secondary infertility. Material and Method: In this systematic review facts extracted by Medline, PubMed, science direct and Obs gyne online library that were queried for studies posted between 2005 to 2021 by using specific MeSH terms. We extracted data from 15 cross sectional studies that was carried out in discipline exercise regions of tertiary care health facility. Results: This study shows data from population surveys reporting on occurrence of number one and secondary infertility. Fifteen research furnished estimates of primary and secondary infertility incidence in 6400 infertile couple. Out of 6400 infertile patients 3600 (fifty six.25%) offering with primary and 2800 (43.2%) supplying with secondary infertility. Age distribution with number one infertility confirmed that the majority of the participants belong to the most fertile age institution. Age distribution of women with secondary infertility confirmed that majority belongs to the age institution of 30–39 years. The primary results of the modern researches had been the primary infertility’s high rate (fifty six.25%) and excessive charge of female factors among infertile couples. Although, it has been said in other researches that female variables (40%), male variables (40%) or a combination (20%) of each could be associated to the causes of infertility. Motive of the couple’s infertility turned into determined on the basis of their examination results and medical history. As compared to the secondary infertility, number one infertility occurrence was higher within the people approaching a tertiary care middle of public zone. Conclusion: From this systematic evaluate we concluded that as compared to secondary infertility, the primary infertility’s superiority is higher. The marriage age is increasing which impacts reasons with male variables and unexplained infertility greater generally observed with increasing age of marriage. Female component stays a principle reason for the infertility including some unexplained reasons and means. In the population coming to a public region tertiary care center, the number one infertility’s prevalence is higher as compared to the prevalence of secondary infertility.

Objective: The purpose of this study was to investigate the causes of infertility in both urban and rural regions. Materials and method: In this systematic review data published by Medline, PubMed, the science straightforward and Obs gyne online library were asked about studies published between 2000 and 2021 using specific MeSH terms. We provided data on 15 phase 6 studies undertaken at a tertiary care facility in rural and urban training locations. Results: In this study, we examined the causes of infertility variability in all habitats. Our revised study shows that fertility rates are very high in small towns and rural areas and very low in the capital, as expected. The study included 7100 married people between the ages of 15 and 49 when 2600 were infertile. The reason for infertility in a couple is assigned on the basis of history and test results. Most women in rural areas are educated. There was a substantial difference between the amount of education and occupation of the site of residence for infertile women. In both rural and urban regions, couples experiencing infertility for less than 5 years were 46 percent and 42 percent, respectively. Women with a familial history of infertility were nearly comparable. In rural places, the history of marriage is common. Female characteristics, male characteristics, and associated features have been claimed to be responsible for infertility in 40percent, 40percent and 20percent of cases, respectively. Conclusion: The poor state of education in rural areas is a major obstacle to encouraging couples to access health care in rural areas. Though PCOS is still a major issue, diseases are still a significant factor in tubal factor infertility, and smoking and liquor enhance the male factor. Most women in rural areas are illiterates. Thus our revised research shows that fertility rates are much higher in small towns and rural areas and compared with the capital due to lack of information and medical services.

Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults. To cope with anxiety, people employ potentially harmful strategies like alcohol, cigarettes, medication, withdrawal etc. which may cause panic disorder to worsen. Gongronema latifolium (GL) is one of the medicinal plants used in the treatment of ailment including mental disorders. This study was therefore aimed to elucidate effects of administration of ethanolic leaves extract of fear and anxiety using light/dark transition box. Thirty (30) adult male Swiss white mice were assigned into three groups of ten mice each, thus: control, low and high dose groups placed on 0.9% normal saline, 200 mg/kg and 400 mg/kg of ethanolic leaves extract of GL respectively. All the animals were allowed food and water ad libitum. Results showed significant (p<0.001) increase in the frequency of line crosses, rearing activities in the extract treated groups when compared to the control. There was a corresponding decrease (p<0.001) stretch attend posture, freezing, grooming frequency and grooming duration in the test groups when compared to the control. These indices show that the extract treated groups of mice exhibited decreased fear and anxiety behaviours when compared to the control group. In conclusion, extract of Gongronema latifolium could be used as an anxiolytic for anxiety related disorders due to its ability to attenuate fear and anxiety related behaviours in mice.

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.