SARS-CoV-2 is spread by the micro droplets from the infected people or by the contact with the polluted fomites. The coronavirus infects the alveolar and bronchial epithelium cells and travels to the tiny air sacs and to alveoli. Monotonous laboratory-biomarkers can give the complete record of health position of a patient in severe medical situations. ACE2 serves as a regulator of renin angiotensin aldosterone systems, which regulates the blood volume, blood pressure, and balance of electrolytes in the body, in addition to acting as a crucial SARS-CoV and SARS-CoV-2 receptor. Transaminases and lactate dehydrogenase (LDH) are nonspecific indicators of cellular inflammation and damage in COVID-19 patients. Biological materials from COVID-19 individuals have been used in various gene expression analysis, as well as those involving proteomic methods. Imaging biomarkers, which also include the magnetic resonance, positron emission tomography, and computed tomography, are categorized into the several groups according to their activities and properties. High neutrophil count, lymphopenia and leukocytes are the simpler preliminary constraints which directly differentiate between the severe and non-severe coronavirus victims.

This paper analyzes the identity crisis of the protagonist James in Everything I Never Told You, explores the contributing factors to his failure to blend in American mainstream society and examines the aftermath of his failure.

Introduction: Leadership is the process of influencing and directing others to be motivated to achieve a goal. Developing leadership in students is part of the authority of higher education institutions and this development program has taken place in almost all universities around the world. Aims: The purpose of this study was to determine the extent to which the development of student leadership behavior at the Faculty of Nursing, Universitas Syiah Kuala (FON- USK). Methods: This type of research is descriptive with a cross sectional study design. Data was collected in May 2018, with the sampling technique used was purposive sampling. The number of samples is 382 respondents. Data collection was carried out using a questionnaire developed by the researcher. Data were analyzed by calculating frequency, percentage. the mean (mean), and standard deviation. Results: The results showed that the student leadership behavior was in the good category as many as 360 respondents (94.2%). With a value of x = 39.68% and SD = 45.21. Conclusion: This means that the leadership behavior of FON-USK students is at the upper middle level (x ̅ /total skor: 39.6/52= 76.5%) and the data are heterogeneous. This leadership behavior is inseparable from the implementation of various learning methods that have been developed by universities that help students to be able to develop self-skills and have a good leadership spirit.

In this study, the influence of Magnetohydrodynamics on free convection slip flow of an exothermic fluid in a convectively heated vertical channel is analyzed. The problem is solved analytically using perturbation series method and expression for velocity, temperature, skin friction, Nusselt Number are obtained and also the influence of some physical parameters such as Hartmann number(Ha), Biot number(Br), Navier slip parameter(γ) and Frank-Kamenetskii parameter(λ) are discussed. It is observed that both velocity fluid and skin friction decreases with increasing value of Hartmann number.

Micro, Small, and Medium Enterprises (MSMEs) are a business sector that has a reasonably reliable resilience in the face of various crises, both monetary and other financial crises, including in the face of the current world condition which is facing the Covid-19 pandemic. The research is empirical legal research using qualitative research. It was conducted in Manado, the capital city of the Indonesian province of North Sulawesi, where many MSMEs require partnership in their development. The results show that the legal aspect related to partnership agreements through Joint Venture Profit Sharing by higher education is the first contract law; normatively, it has provided cooperation with other higher-education parties. However, this law only provides restrictions on cooperation in research and development. It does not regulate participation in the implementation of business activities or the possibility of a contract that clarifies the position of higher education in a partnership agreement. The financial legal aspect, the ideal form of a partnership agreement to be implemented by higher education in developing small and medium enterprises, is partnership through the Development of Science and Technology, partnership through modern cooperatives and partnerships with village-owned enterprises.

Background: The ischemic myocardium should be promptly reperfused to reduce morbidity and mortality in patients with ST-segment elevation myocardial infarction (STEMI). Conventionally, 2 approaches are the mainstay of reperfusion treatment: primary percutaneous coronary intervention (PCI) and fibrinolytic therapy which are considered as mutually exclusive therapeutic modalities. Primary PCI is considered as the gold standard for STEMI but in a developing country like Bangladesh, it is not practically achievable in all the cases because of various challenges. Therefore, thrombolysis followed by either PCI or non-urgent coronary angiography seems to be a more practical approach in not only semi-urban and rural areas but also in metro and tier-1 cities in Bangladesh. Objective: To arrive at a consensus on the importance of pharmaco-invasive (PI) strategy for patients of STEMI in Bangladeshi scenario when a delay in PCI is anticipated. Results: Leading experts across Bangladesh reviewed various fibrinolytics with reference to their availability, ease of administration and risk benefit ratios. Their views were captured in advisory meetings. They then discussed and presented their views and shared their experiences on the practicality of PI strategy in the metro and tier-1 cities of Bangladesh. Their opinion is captured in the present document. The panel opined that STEMI patients should be given PI therapy, wherever possible, using a third-generation fibrinolytic, namely, reteplase or tenecteplase if the delay in primary PCI of more than 120 minutes from the time of chest pain is expected. Immediate reperfusion by thrombolysis helps in preserving the myocardium and it also provides a time window for further PCI and coronary angiography, whichever is required. Conclusion: The experts concluded that when delay in access to primary PCI is expected, PI therapy is the preferred choice for STEMI patients. It should be practiced not only in semi-urban and rural areas but also in metro and tier-1 cities in Bangladesh.

Background: The secondary postpartum hemorrhage occur in 1% of woman and is associated with primary PPH and retained placenta and may result significant maternal morbidity. Objective: To determine predisposing factor and usual management pattern of Secondary PPH. Methods: A descriptive cross sectional study was carried out among secondary PPH patients admitted in the Obstetrics and gynaecology department of Dhaka Medical College Hospital during September 2011 to February 2012. A total 100 patients were taken as sample by non probability purposive sampling technique. Result: Secondary PPH was more common in multiparous woman 75(75%) and lower in primigravida 25(25%) Conclusion: Routine Ante Natal Care motivation for hospital delivery and active management of 3rd stage of labour with aseptic precaution may reduce secondary PPH as well as maternal morbidity and mortality.

Background: The objective of this research was to see how Dexmedetomidine affected the onset and duration of brachial plexus block and postoperative analgesia in individuals having upper limb procedures. Methods: This quasi-experimental study was conducted in the Department of Anaesthesia, Rajshahi Medical College Hospital, and Tertiary Hospital in Rajshahi, Bangladesh. From June 2018 to December 2020. There were two groups of (n=60) adult patients randomly assigned to upper-limb and hand procedures each. When it came to the control group, they were given the same amount of Dexmedetomidine (dexmed) as the dexmedetomidine (dexmed) group. Still, they were also given the same amount of 0.75% bupivacaine and 2% lidocaine (with adrenaline) as the dexmedetomidine (dexmed) 1 μg/kg. Ultrasound-guided supraclavicular brachial plexus block administered a total of 0.5 mL/kg in both groups. In addition to hemodynamic stability, patients were monitored for postoperative pain, analgesia duration, and side effects. Results: The dexmed group had a faster onset of motor blockade and a longer duration of sensory and motor blockade (P < 0.0001). For the dexmed group, the postoperative analgesic period was also prolonged compared to that of controls 12 [10.5–13.5] hours and 17 [10.5–19.5] hours in the control and dexmed group, respectively [95% confidence interval, −5 {−5, −4}, P < 0.0001]). Within the first 24 hours following surgery, the dexmed group used rescue analgesics less frequently. (P < 0.0001). Except for 8 and 10 hours after surgery, postoperative pain scores were equivalent between groups when pain levels were lower in the dexmed group. More sedated individuals in the dexmedetomidine group remained sedated for 2 hours longer. (P < 0.0001). We did not have any occurrences of bradycardia, hypotension, respiratory depression, or disorientation. Conclusions: According to our findings, adding Dexmedetomidine to Bupivacaine-lidocaine increased the duration of the supraclavicular brachial plexus block and reduced postoperative analgesia in patients with upper limb surgery.

Background: Adolescence is the most critical phase of human growth that radically alters the physiology of the body and wherein any inconsistency can lead to serious health consequences in adulthood. In adolescents, the haematological and biochemical parameters change with age, necessitating a continuous age-related definition of the reference intervals. This prospective study aimed to examine the utility of new haematological and biochemical markers to assess nutritional status and possible health risks in children, adolescents and adult boys. Materials and Methods: We performed a cross-sectional study in a sizeable group of 90 male participants aged between 10–22 years to inspect the distribution of values of common haematological and biochemical parameters. Anthropometrical measurements were carried with standard protocols, and blood samples were collected from participants in a hospital setting. Haematological samples were measured using pathology laboratory protocols. Hepatic, renal, lipid and carbohydrate metabolism markers were determined by following standard biochemistry methods. Results: We observed some differences between haematological parameters, hepatic, renal, lipid and glycaemic profiles among children, adolescents and adults. Amongst lipid parameters, only HDL levels were significantly associated with gender following puberty (p< 0.001), the calculated BMI levels were in the lower normal range. Conclusions: This is the first study establishing haematological and biochemical parameters in this part of India. These findings provide a helpful guide for clinical researchers and care providers. Studies on a large scale and in different settings would also be desirable.

Corruption is a special offense that is regulated separately outside the Criminal Code. In the process of handling corruption cases, the principle of priority or precedence in the settlement process applies. This is following Article 25 of Law no. 20 of 2001 concerning Amendments to Law Number 31 of 1999 concerning the Eradication of Criminal Acts of Corruption, which states that investigations, prosecutions, examinations in courts of corruption cases take precedence over other cases in order to be resolved as soon as possible. The problems in this study are how to regulate the law of corruption in order to achieve legal certainty (Research Study at the Tanjung Pinang Police Criminal Investigation Unit), how to implement corruption law enforcement to create legal certainty (research study at the Tanjung Pinang Police Criminal Investigation Unit) and what factors become an obstacle or obstacle as well as a solution to law enforcement for corruption in order to realize legal certainty (Research Study at the Tanjungpinang Police Criminal Investigation Unit). This study aims to determine the legal regulation of corruption in order to create legal certainty (research study at the Tanjung Pinang Police Criminal Investigation Unit), to determine the implementation of the juridical analysis of corruption law enforcement in order to realize legal certainty (Research Study at the Tanjung Pinang Police Criminal Investigation Unit), to find out factors that become obstacles or obstacles as well as Law Enforcement Solutions for Corruption in order to Realize Legal Certainty (Research Study at the Tanjungpinang Police Criminal Investigation Unit). This study uses a descriptive method by using a normative approach (legal research) to obtain primary data through field research. The results of the study indicate that Law Enforcement of Corruption Crimes to Achieve Legal Certainty (Research Studies at the Tanjungpinang Police Criminal Investigation Unit) has basically been carried out well, although there are still many obstacles in the field, especially the substance and legal culture. It is necessary to have a firm legal regulation that provides a deterrent effect to perpetrators of corruption.

Cancer biomarkers are the biological molecules produced by the body or tumor in a person with cancer. In order to place the functioning of biomarkers for clinical investigating, they are passed through different clinical trials in order to check their treatment rate as compared to the normal markers. Different genes are involved in causing the breast cancer and early diagnosis through biomarkers provides an effective way to control the mutations caused in cancerous tissues. Genetic biomarkers are those biological molecules that can detect the change in the DNA and RNA structures. HER2 somatic mutations lead to increase in progressions of cancer development non-small cell lung cancers as well as in breast cells. The most important biomarkers are ALF-alpha-fetoprotein is a protein that in humans is encoded by the AFP gene in the liver. Mutational defect in AFP gene leads to severe damage to liver. C-reactive protein (CRP) is the biomarker for inflammation in the body cells. Prostate specific antigen (PSA) is the biomarker used for detection of prostate cancer. Microsatellite instability analysis of a tumor which provides predictive and also prognostic information. Cerebrospinal fluid (CSF) is the important biomarker for the diagnosis of dementia, Alzheimer’s disease pathologies.

Background: When it concerns to lumbar spine surgery, patients have the option of either general or regional anesthetic. General anesthesia is the most often used anesthetic method (GA). These patients had spinal anesthesia (SA) and general anesthesia (GA) to see which had better intraoperative and postoperative results. Methods: Multicenter non-randomized quasi-experimental prospective study has been conducted in Rajshahi Medical College Hospital and tertiary care Hospital Rajshahi, Bangladesh. From June 2019 until December 2020. The research involved a total of 72 patients. There were 37 patients in the GA Group and 35 in the SA Group who were randomly assigned to the two groups. They also kept track of the patient's heart rate, systolic and diastolic blood pressure, blood loss, satisfaction with the operating circumstances, and the intensity of postoperative discomfort assessed using a visual analogue scale (VAS). Results: This study found that the SA group suffered from considerably less blood loss than the GA group. The SA Group saw substantially less changes in intraoperative maximal blood pressure and heart rate (p=0.05). This group was substantially satisfied with their surgeons' work (p=0.05). There were substantially fewer patients in the SA group who required postoperative analgesics and postoperative mean VAS than in the GA group. (p < 0.05 for both). Conclusions: While maintaining improved perioperative hemodynamic stability without increasing undesirable side effects, our research demonstrated that SA was superior to GA in delivering surgical analgesia and reducing blood loss.

Aims and objectives of the study: The objective of this in vitro study aimed at evaluation with comparision of extrusion of the debris apically using Reciproc, WaveOne with OneShape, Protaper Next rotary file systems. Materials and Method: Sixty mandibular premolars with single root and singe canal were selected. The samples were distributed along four similar groups based on the length between cementoenamel junction and the apex. To collect the extruded debris glass vials with rubber stoppers were used. Pre weighed glass vials were used to collect the debris extruded and the irrigant. Preparation sequences were divided as follows: Group 1: A R25 Reciproc. Group 2: The WaveOne Primary file. Group 3: A classic OneShape file. Group 4: Multiple files ProTaper Next system. Once the instrumentation was completed with respective groups and files, tooth was remoed from the glass vial and root surface was rinsed with 1ml of bidistilled water into the receptor tube.within to make sure the debris accumulated is in the glass vial completely. Preweighed glass vials containing the debris was weighed in an electronic balance with an accuracy of +/- 0.00001g. Results: Readings, data collected, analyzed, computerized with the help of SPSS (STATISTICAL PACKAGE FOR SOCIAL SCIENCES software), 20.0 VERSION. One-way Analysis of Variance (ANOVA) and Tukey HSD test statistical analysis was done. All instruments resulted in extrusion of debris and irrigants, but highest average extrusion of debris was eident in Reciprocting file systems.Conclusion: Among the four different file systems used, Reciproc file system showed the maximum apical extrusion.

It is a well known fact that the urinary stone crystal disease affects a considerable number of people and makes it a major socio-economic problem in the world. Several environmental factors influence the formation and growth of many crystalline materials in the biological fluids in a human urinary system. As in vivo experimentations have limitations, in vitro investigations have been made by several researchers in the past. A success in finding the environmental factors promoting or inhibiting the formation and growth of urinary stone crystals will be of immense help to the mankind. This article provides a bief account of the results obtained in this regard along with providing some information on urolithiasis and gel methods for crystal growth. The focus is made on Whewellite, Brushite and Struvite crystals as these are among the dominant and well studied ones.

Student-centered learning activities are aimed to mastery the learning material for preparing a learning evaluation in the form of examination. However, when monitoring, students were still found cheating. If this reality always occurred, then the degradation of students' competence and character cannot be avoided. Based on the phenomenon found, then it should be solved by implementing scientific-based learning activities through classroom management techniques. Learning activities are the involvement of students in terms of attitudes, thoughts, attention to observing, questioning, acting, reasoning and communicating so that optimal learning conditions are created and maintained, then an atmosphere of learning is conducive and interactive in a classroom management system called face-to-face arrangement. . After the learning activity, an exam is carried out as an effort to overcome the habit of cheating by applying soundproof techniques. During the exam, the situation was conducive even though there was a movement to steal the attention but no one was cheating. This showed a decrease in student cheating. In fact, the classroom management technique with face-to-face settings showed that the stages of scientific-based learning activities have been carried out by students. This was proven by his ability to understand and answer questions both at the time of presenting the results of the assignment and during the exam. By implementing classroom management techniques and scientific-based learning activities, it showed that there is a decrease in student cheating. This is shown from the two classes that were observed when the exam was in progress, only a few students cheated through suspicious movements. Thus, it can be stated that scientific-based learning activities with classroom management techniques are able to overcome the habit of cheating.