Background: This comparative study was conducted to compare the effectiveness of 25 µg of intravaginal misoprostol with intracervical cerviprime gel in terms of efficacy of drug, foeto-maternal outcome, side effects and complications of drugs. Methods: 100 primigravida at term; who were admitted for induction of labour were included in this study. They were randomly selected to receive either intravaginal misoprostol or intracervical cerviprime gel. 50 women received intravaginal 25 µg Misoprostol (Group A) every 6 hours for maximum of 5 doses and 50 women received 0.5 mg (2.5 ml) of intracervical cerviprime gel (Group B) till maximum of 3 doses. Comparison was done in terms of time taken for induction to delivery, mean time taken for onset of labour, APGAR score at 1 and 5 minutes and the neonatal outcome in either of the groups. Results: The mean time taken for onset of labour was less in the misoprostol group than in the cerviprime group (6.5 hours v/s 8 hours, P = 0.49). Similarly duration from induction to delivery was less (20.08 ± 8.24 hours v/s 23.19 ± 9.59 hours, P >0.05) for misoprostol than cerviprime gel. Need for Oxytocin augmentation was less (16%) in misoprostol group as compared to cerviprime group (46%), P = 0.001. Cesarean section rate was slightly higher in misoprostol group (8% v/s 6%). Maternal complications were minimal in either group & the neonatal outcome was good in both the groups. The induction cost was much less in the misoprostol group. Conclusions: Compared to cerviprime gel; misoprostol is safe, efficacious, cheap, well tolerated drug by mother and fetus. It was found to be a better inducing agent, has short induction to delivery interval thus short duration of labour with similar maternal and fetal safety profile.

Papillary Lesions of Breast, defined histologically by presence of fibrovascular cores with varying epithelial proliferation, encompass a wide spectrum of benign intraductal papilloma, atypical papilloma with ADH/DCIS, papillary DCIS, encapsulated papillary carcinoma, solid papillary carcinoma and invasive papillary carcinoma. Due to tumor heterogeneity, sub-classification is diagnostically challenging on histopathology alone thus requiring help of immunohistochemistry (IHC). The aims & objectives of this study was to assess papillary lesions of breast and to determine the histopathological features which can categorize various papillary lesions along with IHC.A retrospective analysis of 39 cases of papillary breast lesions retrieved over a period of 8 years (July 2011 to July 2019) was done. The histopathology was reviewed independently by two pathologists using a standard review form which included 10 parameters. IHC was applied on all the cases to confirm or refute the histopathological diagnosis. Statistical analysis were performed using PRIMER software. Out of 39 cases, the most common papillary breast lesion was benign intraductal papilloma with 28 cases (72%), followed by one case of atypical papilloma with DCIS (2%) and 10(26%) malignant papillary lesions. The statistically significant histopathological features which aided in differentiating benign lesions from malignant lesions were presence of apocrine metaplasia, bland nuclear features and absence of atypia. IHC was necessary in diagnosing all the malignant papillary lesions and 2 benign papillary lesions. Papillary lesions of breast are difficult to interpret on microscopy alone due to intrinsic heterogeneity. The combination of histopathological features along with IHC helps in distinguishing benign, atypical and malignant papillary lesions.

Cotton belongs family Malvaceae, genus hirsutum and tribe Gossypiae, and it is usually divided in to two types: the wild and the cultivated cotton. To understand the molecular base of the plant reactions to main abiotic stresses like salinity and drought is important for bio-technological applications of stresses adaptations for crop development. In this perspective, thousands of stress receptive genes are recognized and a small number of them are characterized functionally. Thrilling temperatures, salinity and the water reduction are major abiotic stresses which are reflected the primary issues, which reduces the cotton production. The global drop of cotton crop is fifty percent due to abiotic stresses or supreme cotton crop yield; they need optimal growth situations like the other field crops. Due to drought stress response, boll of cotton plant and its leaf area is reduced and any change in carbon uptake also put its impact on photosynthesis. Polyphenolic with capable contraceptive reactions, a gossypol and terpenoids with anti-inflammatory effects and cytotoxic activities of trans-caryophyllene are some examples of potential chemical compounds present in cotton with their valuable impacts on humans and animals health as well. . Cotton seeds are now inspected as most potential co-product and a high valuable part of cotton processing chain and it is most viewed left over by product of cotton.

Many of the immune cells are involved to protect the body against the specific microbes and thus inhibiting their chemicals by binding to the specific surfaces of pathogens. Human body has different cells particularly important in defending the body against the pathogens. Different cells are involved in protecting the body as part of innate immunity. This innate immunity includes the external barriers of the body as the first line of defense against pathogens such as the skin. Molecules on the pathogens surface may be recognized directly by the PRRs of resident macrophage. Natural killer cells also involved in immune response by killing the cancerous cells or viral proteins by attaching on their surface. The main mechanism of the innate immune response to eradicate bacteria is activation of the complement system, phagocytosis, and inflammatory response. Listeria monocytogenes is the pathogenic form of bacterial species that causes disease transmitted through the infected foods. Interferons tightly bind to the viral proteins and inhibit their production. Different vaccines have been used to treat the number of diseases and each vaccine works for against the specific diseases in order to make the immunity.

Preterm Premature Rupture of Membranes is a familiar anxious problem of pregnancy that is interconnected with substantial perinatal difficulties. It is defined as a breaking of amniotic sheaths earlier to 37 weeks’ pregnancy and earlier to the beginning of labor pain and occurs about eight to 10% of pregnancies. Objective: To describe the experiences of preterm premature rupture of the membrane in women admitted at Khyber Teaching Hospital Peshawar, Pakistan. Methods: Qualitative study was developed and the sample size was nine women in their third trimester of pregnancy. The purposive sampling technique was used. An in-depth interview method was applied for data collection. Results: The themes identified in this study were five, which included the varied experiences of women, Preterm Premature Rupture of Membranes patients, delayed visits to clinics for treatment, social and psychological stress, and lack of education, awareness, and proper diet. Membrane ruptured before the expected date of delivery leads to so many problems for both maternal and fetal health. The bigger socio-economic burden on the patients’ families is related to stress and anxieties. Conclusion: The membrane ruptured before the expected date of delivery leads to so many problems for the woman and her family. The principal point was the hospitalization and has increased financial burden on family members.

Pleurotus tuber reguim is a mushroom widely used as food, and in traditional medicine for weight loss and treatment of headache, fever and stomach pain among other ailments. This present study is aimed at the evaluation of antihyperlipidemic activities of chromatography fractions obtained from an earlier reported anti-hyperlipidemic chloroform extract of Pleurotus tuber reguim using triton X-100 induced hyperlipidemic rat model as well as investigate the phytochemical constituent(s) from the active chromatography fraction(s). The pulverized sclerotia sample was extracted exhaustively by cold maceration with chloroform and the chloroform extract (6.42g) fractionated on a chromatography column(silica gel G, 200 -400 mesh-stationary phase) eluting with a gradient mixtures of n-hexane: chloroform: methanol (4:0:0; 3:1:0; 1:3:0; 0:1:0; 0:3:1; 0:2:2; 0:1:3; 0:4- v/v/v). Fractions with similar chromatography fingerprint on thin layer chromatography examination were pooled. Phytochemical screening was done using standard methods. The chloroform extract afforded four pooled chromatography fractions (F1, F2, F3 and F4). The trend: Total cholesterol [atovastatin (47.5%) > F1 (42.3%) > F2 (37.6%) > F4 (29.9%) > F3 (29.8%)]; Triglyceride [F4 (47.6%) > F1 (44.8%) > Atorvastatin (35.6%) > F3 (32.9%) > F2 (4.3%)]; High density lipoprotein-cholesterol [F2 (101.3%) > F1 (91.2%) > atovastatin (53.7%) > F3 (17.7%) > F4 (14.9%)];Very low density lipoprotein-cholesterol [F4 (47.6%) > F1 (44.8%) > Atorvastatin (35.7%) > F3 (32.9%) > F2 (4.3%)]; Low density lipoprotein-cholesterol [Atorvastatin (12.5%) > F2 (10.0%) > F1 (7.6%) > F3 (3.5%) > F4 (-4.9%)]. Fractions F1 and F2 where found to contain triterpenoids and fatty acids while fractions F3 and F4 were found to contained amino acids or peptide derivatives. Pleurotus tuber reguim exhibited hyperlipidemic activity and the presence of triterpenoids and amino acids or peptide derviatives could be responsible for the observed trend in antihyperlipidemic activity.

Plurihormonal pituitary adenomas are rare tumors that present cellular immunoreactivity for more than one pituitary hormone. The most common form is that combining growth hormone and prolactin, but the combination of growth hormone with adrenocorticotropic hormone causing Acromegaly and Cushing's disease is extremely rare and clinical signs may be subtle. We have demonstrated the clinicopathological characteristics of plurihormonal pituitary adenomas through the case of our 25-year-old patient who had a pituitary macroadenoma with an initial clinical picture dominated by acromegaly and mild cushingoid features.

Accomplishing any jumbled task demands organization, coordination, and discipline. Overseeing a Bioequivalence study is certainly in the same manner, to guarantee that the trial works successfully, good project management is necessary. Project Management in a CRO necessitates competence in a variety of areas, including time, quality, cost, scope, risk management, communications, and sponsor management, and many others. The current review focuses on how to plan each phase of the study and how to create an effective Project Management Plan to reduce the average duration of the study and project management risks. The review also advises to follow a standard operating procedure at all times when conducting Bioequivalence study.

Objective: To evaluate the predictive values of urinary calcium creatinine ratio and microalbumin in pregnancy for detection of patients who are going to develop pre-eclampsia. Methods: Spot urine samples were taken in 150 asymptomatic pregnant women between 20-28 week of gestation to determine Urinary calcium creatinine ratio and micro-albuminuria in outpatient department of TRS, hospital. The statistics was analyzed using Chi square test and t test for determine the significant association of clinical findings of pre-eclampsia to CCR and micro-albuminuria. The predictive values of CCR equal to 0.04 or < 0.04 and microalbuminuria were determined by Area under Receiver Operator Curve (ROC) for pre-eclampsia. Results: The Calcium to creatinine Ratio found to be a good diagnostic test for prediction of pre-eclampsia with sensitivity, specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV) of 83%, 96%, 75%, and 98% respectively. The statistical accuracy of 95% and significant p value of <0.001. The microalbuminuria is came out to be fair diagnostic test to prediction of pre-eclampsia with sensitivity, specificity, PPV and NPV of 65%, 86%, 42% and 94% respectively. Conclusion: CCR to be recommended as a good screening test for prediction of preeclampsia at cut off value of 0.04 in spot urine sample of all pregnant women without any symptomatology while microalbuminuria is a fair test for same at present.

Supernumerary teeth (SN) teeth are a relatively rare phenomenon that can occur anywhere in the dental arch. This report represents a case of a young female patient that is presented with one SN tooth specifically mesiodens, which prevented her upper central incisor from erupting in its normal sequence. This patient also reported to have a congenital complete duplex of left kidney that has much smaller upper pole and a normal size lower one, with a sperate ureter of each, and growth hormone deficiency. This is a non-syndromic patient. In the literature review there has been some linking between growth hormone deficiency and SN teeth. However, up to this research in the literature, no case was found linking between complete duplex of kidney and ureter, and SN tooth. This report also viewing radiographic CBCT regarding mesiodens, in three views (coronal, sagittal, and axial).

Different physical and chemical techniques used for discovery of innovative nanoparticles with emerging applications in the fields of x-ray diffraction that can use as most important technique for optical measurements of nanosacle objects. Silver and gold nanoparticles formulations can be easily accessed through the different methods such as lithographic and vacuum deposition of metal, but appeared to be expensive techniques. Semiconductor based nanoparticles possess the magnetic properties with excellent electrical conductivity due to which they are used in different appliances and engineering works. Semiconductors have introducing impurities into their crystal lattices through traditional techniques or methods that designed at industrial and commercial level. The photovoltaic cells that synthesized through nanotechnology approach possess the photofunctional materials; nanoscale architectures usually exhibit unique optical and electronic properties. One of such kind of example is the alternative technologies to silicon based chip with combinations of various parts through nanotechnology.

Fermented foods have special functional qualities that provide consumers with health advantages owing to the presence of active microorganisms that include probiotic capabilities, antibacterial, antioxidative, peptide synthesis, and other properties. The bacteria like lactic acid bacteria are used in the production of cheese, pickles and yoghurt. Moreover, extensive types of molds are used in sausages surface ripening, in preserving products natural quality and are used to control the formation of unwanted flavors in different products. The determination of contaminated food with microorganisms is not possible without testing microbiologically. Staphylococcus aureus is the most dangerous type of bacteria and the main source of its infection are humans. The foods which are contaminated with C.perfringens, when consumed a toxin is produced in human intestinal tract and cause illness. The two main food borne types of viruses are the norovirus and Hepatitis A. Vector borne spread of disease occur when a parasite goes in host by the saliva of insect during the blood meal such as malaria, or from the parasites present in feces of insect which excretes directly after the blood meal. It's also important to understand how the cell detects the presence of the pore, whether it's through ion concentrations.

Intestinal worm infestation is the commonest form of helminth infections in human, which affect a great proportion of the world’s population and children are the most vulnerable population among them. Intestinal worm infestation is the major risk to community health which adversely contributes to the prevalence of malnourishment in developing countries. The World Health Organization estimates that over two billion people are affected with helminthiasis. Unani physicians described intestinal worms as Deedan e Ama’a and they are of opinion that the excessive putrefied phlegm is the cause for the formation of intestinal helminthiasis and the presence of worms always depends on mal-temperament or imbalance of phlegmatic temperament and unhealthy living conditions. Exploration for further alternative therapeutic agents for the treatment and control of helminthic infections has become crucial at present. Various single and compound drugs have been described in Unani literature for the treatment of different types of worm infestations and Unani physicians prescribed them since antiquity. It has been observed in routine practice that the compound formulations are more effective compared to the single drug. This systematic study was focused to assess the scope of herbal medicine in the treatment of worm infection.

Introduction: Tibial fracture is one of the commonest bony injuries associated with increasing number of road traffic accidents in developing countries. The long bone contains long medullary canal & have a subcutaneous position. Reaming of medullary canal may increase the chances of fat embolisms syndrome & increase the inflammatory response. Controversy prevails between reaming & unreaming of the medullary canal as considered the fracture union, ease & short surgical time & systemic complications. Objective: The objective of the study is to evaluate the results of short surgical time & unreamed vancomycin dipped tibia interlocking nail surgery in hanging leg position for tibia fractures. Material & Methods: In this study total (n= 49) cases of tibia fracture who underwent unreamed tibia nailing were evaluated retrospectively. Among (n=49) cases (n= 35) 71% were males & (n=14) 29% were females. According to Ellis classification (n=20) patients had mild, (n=25) patients had moderate & (n=4) patients had severe variant. Results: In the study total number of cases with tibia fracture included where commonest mode of injury was vehicular accident (n=40) (82%) and fall from height (n=9) (18%). Patients who were operated late had associated injuries that prevent early operation. Rust score was used for radiological union score. Mean value of rust score for this study was 8.8 with Inter observer agreement among all three reviewers was substantial, with ICC=0.78(95% CIs 0.65-0.90). Follow-up duration varied from 1 to 6 months with one patient had infection at surgical side and went for debridement and intravenous antibiotics for recovery. Conclusion: Unreamed interlocking tibial nailing can be safely used for type-I and type-II open injuries even with delayed presentation. Compared to reamed nail there is ease of technique application and the decreased operative time in unreamed interlocking nailing.

Since the emergence of the Corona virus and its spread to become a global pandemic, many changes have occurred in human life, and it was necessary to unite the world and exchange experiences and experiences in overcoming this disease and its negative repercussions on all sectors and levels that imposed new habits on individuals, the most important of which is shopping through digital technologies to obtain them, Therefore, this study aimed to investigate the impact of digital marketing on the SME sector to create value for customers. To achieve this, the comparison method was adopted for previous studies. It was found that digital marketing has an effective role in reaching customers and marketing products electronically, in addition to that social media platforms were among the most effective tools in Jordan, and stakeholders should focus on digital marketing in the SME sector, especially by relying on social media platforms to benefit From this opportunity that the epidemic imposes on customers, which increases the strength of this sector to overcome the crisis and enable it in the future. The SME sector in Jordan is considered one of the most important sectors that support the Jordanian economy due to its daily activities, job opportunities and rapid financial exchange.