Introduction: Coronary artery disease is the commonest form of heart disease and the leading cause of morbidity and mortality throughout the world. Its prevalence among Bangladeshi has doubled during the past two decades. Myocardial infarction is one of the most common diagnosis in hospitalized patients. Objective: To find out the clinical profile of right ventricular infarction in patients with inferior wall MI. Methods: The study was a hospital based observational cross sectional study. 30 consecutive patients of Inferior wall myocardial infarction as proved by E.C.G. admitted from June 2019 to June 2020 to the ICCU, Department of Cardiology, Al-Helal Specialized Hospital Ltd. Mirpur, Dhaka, Bangladesh. All the Patients were studied at the time of admission, during management in hospital and followed up in the hospital until recovery or death. Criteria only patients with definite evidence of IMI in 12 lead standard ECG were included in this study. For these patient’s additional Right Precordial leads were taken at the time of admission and repeated at 12 hours, 24 hours and 48 hours. Result: Out of the total 150 cases of acute MI admitted in Al-Helal Specialized Hospital Ltd. Dhaka, Bangladesh. The incidence of IMI among all the cases of AMI was 20.0% our study showed a peak incidence of RVI in the age group of 51 – 60 years but the peak incidence of IMI was in the age group of 61 years above. Our study showed a very high incidence of IMI and as well as RVI in males compared to females. This may be due to association of many risk factors which is more common in males. Our study shows percentage of various risk factors associated with MI. In most of cases multiple risk factors co-existed. In our study chest pain was the commonest symptom followed by sweating. Syncope was essentially an important presenting symptom in RVI. Palpitation was the least presenting symptom in IMI. In our study ST segment, ST of RV4 was elevated in all the 15 cases of RVI, ST elevation in all four leads (RV3, RV4, RV5 and RV6) was in 8 cases, ST elevation in any lead in 7 cases and ST of V1 was elevated in 9 cases. The incidence of VF was significantly high in cases of RVI and it was a major cause for mortality. Mortality is significantly high in RVI were as it is lower in IMI without RVI. Conclusion: The incidence of mortality and complications can be reduced only when we are fully aware of the diagnosis and the complications that can occur in RVI. So in all cases of IMI, RVI should be looked for by using simple and specific investigation like RPLs of ECG. Clinically RVI can be suspected when there is bradycardia, irregular pulse, hypotension and elevated JVP with clear lungs in a setting of Acute MI. ECG is a very simple investigative tool. The Advantage of ECG is it is easily available, noninvasive, cost effective, specific and sensitive. Involvement of the right ventricle in inferior wall myocardial infarction significantly affects the mortality and morbidity and complications.

A theme is a major topic, matter, or statement inside a tale and symbolism is a literary method that employs symbols, whether the words, characters, markings, places, or abstract concepts symbolize something more than the actual meaning. Thematic concepts refer to what readers "believe the work is about," while thematic statements are "whatever the work expresses about the topic". The major goal of this proposed study was to examine and debate the thematic concerns and symbols found in Zaib-Un-Nisa Hamidullah's novella ‘The Bull and She Devil’. She is regarded as a pioneer of feminist literary studies in Pakistan. Her contribution to the field of English literature is noteworthy. ‘The Young Wife and Other Stories’, a collection of her short fiction; deals with the impression and expression of sexuality in state of depression in a male dominated society. Nature of this research work is qualitative, and it explains various themes and symbols used in the story. Sample of the study is “The Bull and the She Devil”, a story taken from Hamidullah’s afore mentioned collection of short stories. Study discusses the mental approach and dilemma of the rural young man’s physical, psychological and emotional state regarding marital relationships with his wife along with the plight and repressive state of mind of females in male dominant societies. The author skillfully interacts with forbidden issues without being too overt with help of symbolic representations and thematic interpretations.

The study investigated on demographic determinants of executive manager stress in Rivers State. This study was guided by three research questions and three corresponding null hypotheses. The demographic factors investigated included gender, age and educational qualification. The descriptive survey research design was adopted with a sample of 400 administrators drawn from the entire population of administrators in Rivers State. Data for the study was obtained using a 20 item researcher-developed instrument which was adequately assessed for validity and reliability before administration. Mean and standard deviation were used to answer the research questions, while independent samples t-test was used to test the corresponding null hypotheses. Result revealed that female had a significantly higher level of stress than males, that younger administrators had a significantly higher level of stress than older administrators, while administrators with graduate degrees had a significantly higher level of stress than those without graduate degrees. Based on these results, it was recommended that stress management training should be provided for administrators in Rivers State.

Qillat-i-Darqiyyat (Hypothyroidism) is one of the most common disease conditions under endocrine system, occurring in 5% of individuals. A 19 years old female patient, approached the Outpatient department of NRIUMSD, Hyderabad, with complaints of weight gain, loss of hair, poor appetite, and general weakness and was treated with Unani medicines i.e., Asgand (Withania somnifera) and Brahmi (Bacopa monnieri) for 8 weeks. All the basic blood and urine investigations were done before and after the treatment along with the thyroid profile test. After 8 weeks of treatment, the patient showed significant relief in symptoms as assessed by a decrease in Zulewski's clinical score which was 7/12 point before treatment and 4/12 points after treatment, and a decline in TSH level from 6.73 µ IU/mL to 2.53 µ IU/mL. Although, the serum T3 and T4 levels remained within normal range during the course of treatment. Thus, this study is suggesting that Unani medicine can be used effectively in the management of Hypothyroidism.

Introduction: Patients with advanced multivalvular disease (AMVD) and left ventricular dysfunction carry usually a higher in hospital mortality. However, long-term survival results improved in some causes. Design: Retrospective study, teaching hospital based. Methods: 82 patients (59 men and 23 women) mean age 44,5±13,6 years with left ventricular ejection fraction (LVEF) ≤ 45% underwent multiple valve surgery from 1994 to 2016. The most common etiology was rheumatic valve disease (89%). 90, 2% of patients were in NYHA class III-IV. Mean LVEF was 38, 4±6, 3%. Triple valve surgery was performed in 38 (46, 4%) cases and double valve surgery was performed in 44 (53, 6%) cases. All tricuspid procedures were conservative (51 cases; 62, 2%): DeVega in 22 (43, 1%) cases and Carpentier Edwards ring in 29(46,9%) cases. A logistic regression analysis was used to identify the determinants factors of early mortality. Results: In-hospital mortality was 17% (14/82).In multivariate analysis, factors influencing operative mortality rate were: preoperative renal failure (OR 9.6, 95%CI 1.28-72.4, p=0,027) and LOS (OR 19.8, 95%CI 1.8-218.4, p+0,015). Follow-up was 35% complete and follow-up period was 48 months (range 12-108). There is a significant change in NYHA functional class (p<0, 0001) and most survivors showed an increase LVEF (p<0, 0001). Conclusion: Multiple valve surgery in patients with AMVD and left ventricular dysfunction can be performed despite early mortality rate. But the good late results justify surgical indication and those patients should not be denied on the basis of low ejection fraction alone.

At the end of 2019, COVID-19 (SARS-CoV-2) has become a global pandemic with severe acute respiratory syndrome. The virus started from Wuhan, China on 29 December 2019 and spread widely all over the world in a short period. The present review reports the activity of one striking lichen; Cetraria islandica (L.) Ach. as probable complementary effective treatment for symptoms associated with Covid-19, infection. Many potential treatments have been introduced, which are considered potent antiviral drugs and commonly reported as herbal or traditional and medicinal treatments. Currently, several studies confirmed that herbal medicine plays a major role in the prevention and treatment of many diseases also for the novel coronavirus. As well as, the post-COVID syndromes which have been detected in many people who've "recovered" from COVID-19 but still suffering from its pulmonary symptoms. In the light of findings reported in the present study, C. islandica supplements can add a significant role to protect lung from COVID-19 symptoms and post-COVID syndrome alongside with synthetic drugs or vaccines. Therefore, C. islandica supplements have the potential of being utilized as novel bio-resources for naturally occurring phytotherapies.

The EtOAC fraction of the partitioned MeOH portion of the leaf extract of A. muricata was subjected to Si-gel column chromatography. Similar fractions where pooled together on the basis of their TLC profile. This was further re chromatographed on silica gel chromatography to afford red crystallized needles as compound 1. The EtOAC from the partitioned MeOH portion of the stem bark extract of A. muricata, was also subjected to column chromatography, similar fractions with TLC profiles where pooled together and subsequently subjected to a repeated gel filtration techniques over sephadex LH 20 to afford compound 2.Their structures were elucidated as2-(1-methoxy-carbonyl-4-6-dihydroxyphenoxy)-3-methoxy-5,6-di-(3-methoxyl-2-butenyl)-1,4-benzoquinone (1) and 1-O-(4"-O-Caffeoyl)-β-glucopyranosyl-4-dihydroxy-2-(3',3'-dimethylallyl) benzene (2) using standard spectroscopic protocols.

Menopause is an endocrinological transition that greatly affects health and disease susceptibility in middle-aged and elderly women. To gain new insights into the metabolic process of menopause, plasma metabolic profiles in 60 pre- and post-menopausal women were systematically analysed by biochemical methods in conjunction with univariate and multivariate statistical analysis. Biochemical markers signatures revealed considerable differences between pre- and post-menopausal women, and clear separations were observed. In total, five metabolites were identified as potential biochemical markers for menopause, including serum calcium, phosphorus, vitamin D, serum alkaline phosphatase and osteocalcin. These differences highlight those significant alterations occur in serum metabolism, biochemical reactions, hormone imbalance in post-menopausal women. In conclusion, our plasma biochemical study provides novel understanding of the metabolic profiles related to menopause, and will be useful for investigating menopause-related diseases and assessing metabolomic confounding factors.

Coronary heart disease, non-communicable disease has become epidemic and increasing in world crisis. There is escalation in developing countries and known to be the death cause in developed countries. Due to the absence of proper guidance and preventive measures its risk factors are increasing day by day. 30-40% of deaths in Pakistan are due to cardiovascular disease. Study of C-reactive protein relationship with cardiovascular disease risk factors is essential for heart disease patients. C-reactive protein is an inflammatory marker it’s helpful tool for the recognition of risks in developing heart disease. C-reactive protein assessed by Enzyme Linked- Immunosorbent assay method is more effective in comparison with other risk factors of cardiovascular disease such as obesity, blood pressure, diabetes mellitus, cholesterol, Triglycerides, LDL cholesterol and HDL cholesterol. Written consent filled by the patients was studied to understand the relative relation of C-reactive protein with other parameters. Systolic and diastolic blood pressure mmHg was measured at 5 minutes of interval for the average analysis. By statistical analysis on Graph Pad Prism we have found the prevalence of C- reactive protein in heart patients in reference to their physical activity, smoking status and stress. Statistical means of h heart patients and control were compared to each other and there see mainly increase in level of CRP, LDL cholesterol, Triglycerides, diabetes mellitus and total cholesterol. High density lipoprotein cholesterol was low in patients and higher in control because this is the good cholesterol. Total number of heart patients is 50, and 15controls. C-reactive protein in heart patients is (4.594±0.2099***) at a 95% of confidence interval whereas in control it was 1.42±0.1776. Statistical value of total cholesterol is 246.1±7.081*** in heart patients and in control (173.7±7.909). There was significant association of all parameters with coronary heart disease.

Defence applications to adduce evidence in Meng Wanzhou’s extradition case. Bases of Court decisions to allow or deny evidence. Different standards required for Requesting State and Person Sought. Extradition proceedings constituting a trial of the Record of Case, not of the Person Sought. Unfairness flowing from the new Extradition Act due to relaxation of evidence standards required in the Record of Case. Whether Extradition Act achieved its aim to prevent Canada being a haven for criminals, or if it has become one of the easiest places from which to extradite, creating concerns about wrongful extradition and denial of Charter Rights.

Background: Gestational thrombocytopenia (defined as a platelet count below 150 x 109 /L) occurs in 5% to 10% of pregnancies. Thrombocytopenia is the second leading cause of blood disorders in pregnancy after anemia. A low platelet count is often an incidental feature, but it might also provide a biomarker of a coexisting systemic or gestational disorder. Timely analysis is needed to determine the primary cause of thrombocytopenia, and appropriate therapy should then be selected to effectively improve the prognosis of the pregnancy. Hypertensive disorders accounts for 33% of all the cases of thrombocytopenia in pregnancy. Methods: The study was conducted at a tertiary institute over a period of one year, from April 2020 to March 2021. This is a retrospective study of indoor patients admitted with the low platelets in the department of obstetrics and gynecology at Smt. Kashibai Navale Medical College and General Hospital. All Pregnant women with platelet count less than 150 x 109 /L were included in the study. Results: Most of the cases presented during 34-38 weeks of gestation. The most common etiology of thrombocytopenia at our place was found to be pregnancy induced hypertension. Conclusions: Thrombocytopenia in pregnancy may occur secondary to a variety of causes. Most of these cases occur during specific periods of gestation. Thrombocytopenia in pregnancy if timely diagnosed do not cause any mortality, however management of these patients require a multidisciplinary approach and close collaboration between obstetrician, physician, and neonatologist.

Background: Worldwide hypertension is the third leading risk factor contributing to death, preventive measures and control of high f blood pressure should be of high priority, a healthy lifestyle remains the cornerstone of the management of blood pressure (BP). Objectives: To evaluate the effect of self - care life style modification program on self-efficacy for hypertensive patients using the Health Belief Model. Sudan, 2018. Methods: A hospital- based prospective study was performed at shendi town –sudan(March- April 2016 – febrery 2018). A total of 101 adult individuals were interviewed using structured questionnaire. That was filled by researcher, trainer nurses and semi-final medical students. BP was measured. The international classification of BMI was used for weight measurment. Analysis: selection of subjects was done via convenience sampling, they were followed during a 7 month, descriptive and inferential statistical methods were employed to analyze data. Results: This study reflected that majority 81(80.2%) of study group were ≥ 50 year of age the mean age of them was 57 ± 9.9 (range 30–83) , the study groups knowledge about hypertension improved in post -test phase, and upgraded in follow up- phase with highly significant results , they had improved level of life style modification upgraded in pos-ttest and follow up- test (P < 0.05). Conclusion: This study showed that the educational program was effective in increasing knowledge, improving self-care, and controlling lifestyle habits of hypertensive subjects, and indicated the ability of Health Belief Model in self-regulation and reducing the blood pressure. Thid study reflected that barriers to practice life style presented that more than one third 35(34.7%) of study group reported ineffective of medication to stabilize their blood pressure as a personal barrier, less than one third 30(29.7%) had self-efficacy as a psychological barrier, more, more than half 54(53.5%) reported confidence to implement strategy as a provider barrier, than two third 79(78.2%) reported lack of social support as a Sociocultural barrier, more than two third 68(67.3%) reported complicity of the regimen as a therapy related barrier, majority 88(87.1%) reported lack of transport as barrier to access to care, majority of them84(83.2%) reported lack of office support was a barrier as a feature of practice setting.

Aims and Objectives: The aim of the study was to evaluate the prevalence of awareness among dental interns regarding endodontic flare ups and its management. This cross-sectional survey was targeting the 2017-2018 patch of dental interns in all the dental colleges around the western region of Saudi Arabia which include: Ibn Sina national college, King Abdulaziz University, Al-Farabi and Al-Bateerjee colleges in Jeddah, also Um Al Qura University in Makah and Taibah University in Al Madina. Methods: A total of 294 participants in this cross-sectional survey divided into two parts 16 closed-ended questions in which first part of the questionnaire assessed the demographic profile of the Interns such as age, gender, and the Institution they belong to. The second part consisted of 12 multiple-choice questions to investigate their knowledge and awareness about endodontic flare up and its management. The study targeting the 2017-2018 patch of dental interns in all the dental colleges around the western region of Saudi Arabia. Relationship between these factors and are‐ups was examined. Statistical analysis was done using Pearson Chi-square test and Fisher’s exact test. Results: majority of the students having the higher incidence of flare-ups with Necrotic pulp [52%] while [41.5%] student participants, the best choice of treatment for cases of severe inter-appointment pain is re-instrumentation, occlusal reduction, antibiotics, and analgesics. Conclusions: Flare-ups develops due to many factors, which are directly interdependent and interrelated. Incorrectly measured working length of the root canal is a mechanical factor causing the damaging effect of the chemical and microbial factors to the apical periodontal tissue. Development of the flare-up after the endodontic treatment procedures is also influenced by demographics, general health, clinical symptoms, condition of the pulp and apical periodontal tissue, tooth being treated, number of visits during the treatment and intracanal medicaments. Women compared to men are more prone to are‐ups.

Metastatic tumors to the oral cavity affecting either the jaws or the soft tissue are unusual and accounts approximatively for 1% of all oral malignant neoplasms. Morever, a thyroid primary tumor is considered almost rare. The present paper describes a case of metastatic follicular thyroid carcinoma to the right maxillary sinus, bone and alveolar mucosa in a 73-year-old male patient. Our aim is to highlight the importance of considering oral metastasis in the diagnosis of jaws and soft tissue lesions especially in patients with known primary malignant tumor.

A multi-location experiment was conducted at three locations of New Halfa irrigated scheme, Hajer, the Faculty and Elshebaik sites, for two consecutive seasons 2017/2018 and 2018/2019 to test the effect of 18 organo-chemical fertilizer levels on growth attributes, yield and yield components of two wheat genotypes Bohain and Debaira. The results of analyzed data showed that. In both seasons, the growth attributes, such as the plant height, number of leaves per plant, leaf area (cm2) showed non-significant differences for both genotypes under the different 18 fertilizer levels at Hajer and the Faculty sites. However, these traits are significantly different (P≤ 0.05) for both genotypes at Elshebaik site. Contrary to the growth attributes, the effect of the organo-chemical fertilizer was highly significant (P≤0.001) for the yield and most of its components for both genotypes in both seasons and at the three sites of study. The yield of both genotypes at the three locations is better in the first season compared to the second one. Debaira yield for both seasons and at the three locations is better than the yield of Bohain. From this study, it is clear that the yield of both genotypes increased with addition of the organic manure. From the results obtained in this study, it could be concluded that, Debaira scored better yield per h (kg) compared to Bohain genotype in both seasons and at two locations, Chicken manure up to the rate of 4 ton /h. when combined with 43kg N/h and 43kg P/h improved the yield of both genotypes in both seasons and at the three locations.