Obstructive sleep apnea is characterized by repetitive episodes of complete or partial collapse of the upper airway during sleep. Prevalence of obstructive sleep apnea is favored in men more than woman with a ratio of 2-4:1. Risk factors include nasal obstruction, obesity, gender, craniofacial anatomy, and smoking. Reoccurring symptoms, such as daytime sleepiness and irregular snoring have lead scientists and doctors to further find appropriate means of diagnosis. Polysomnography is proved to be the golden-standard method for diagnosing obstructive sleep apnea. Other diagnostic tools include taking a home apnea test. Positive airway pressure and oral appliances are the two most common non-invasive devices used to treat obstructive sleep apnea. Surgical procedures, like uvulopalatopharyngoplasty and maxillomandibular advancement are the most effective surgeries, especially in severe cases. Obstructive sleep apnea also arises complications and side effects that do not only affect the patient’s physical health but also impact their social and mental well-being; however, there are means to prevent it and lead a healthy lifestyle. In this review, the abovementioned aspects of obstructive sleep apnea are focused on and supported in detail.

Rasa Shastra forms the core of the Ayurvedic treatment that mainly deals with Parad and a vast number of minerals, metals and animal products having therapeutic as well as alchemical importance. In Rasa Shastra metals and minerals depending on similar composition/properties to different Vargas (groups). Sikata varga is compounds of silica-containing group of drugs having enormous therapeutic value. Classification of Sikata varga was not use in classical manuscripts, the scattered description of features, types and processing into formulation of these drugs and their usage in alchemy; various methods of binding of mercury (Parada bandhas) as well as internal administration were enumerated. Authors of 20th century have grouped these drugs under a specified class called Sikata Varga. The current work has been made to systemic compilation of all scattered information in one place for easy and better understanding of all Sikata varga Dravya in Ayurveda.

Celiac disease (CD) is a chronic immune mediated enteropathy induced by the ingestion of gluten in genetically predisposed individuals. In cases of long term evolution and poor adherence to gluten-free diet (GFD), the outcome of CD may be the development of malignant diseases mainly lymphomas that can be responsible of a higher mortality rate. In some rare cases, the diagnosis of CD is made upon the discovery of the lymphoma. The main histological type is the enteropathy-associated T-cell lymphoma but can also be a B-cell kind. We report here the case of 02 patients with lymphomas revealing a CD.

Epilepsy is one of the most common neurological disorders, nearly 70% of patients with epilepsy lack an obvious pathogenetic cause, genetic is believed to play an important role in its causation. Objectives: to determine the association of sodium channel SCN1A gene mutation with epilepsy. Methods: The current study is a cross-sectional study that had been performed at Sheikh Mohamed Khair centre, Banat, Omdurman, and National Centre for Neurological Sciences (NCNS) Khartoum state, during the period November 2016 to February 2019. Ninety-nine patients were enrolled in this study. Demographic data were collected in a predesigned questionnaire. Blood samples were tested for biochemical and molecular tests. Results: sequencing analysis detected AT deletion in 71% of the samples. Conclusion: Genetic mutations have an effective role in developing epilepsy, AT deletion in SCN1A gene, indirectly, affects Gamma aminobutyric acid function which is inhibition of neuronal activity.

Coronavirus has taken it serious form and also causes the death once damage the air passage ways into particular host. This virus is transmitted from the air droplets of the infected person. There are variety of responses agonist the Covid-19 by innate immunity that particularly recognized the cells of this virus as a pathogenic form and fights against them. It can be recognized through the pathogen associated molecular patterns. Type I IFNs are mainly involved in activation of other cells of immune system that contribute to immunity. Helper T cells are the main cells for defense against the viral cells. Helper T cells are the directors of the cellular immunity against SARS-CoV-2. There are different parts of the adaptive immune system work together, so seeing Covid-fighting antibodies, memory B cells, memory CD4+ T cells and memory CD8+ T cells in the blood more than eight months following infection is a good sign. Remdesivir as one of the antiviral drug binds to the particular cells of virus at cellular level by binding to the viral RNA. Tocilizumab as one of the approved drug by FDA for treating the Covid-19. Dexamethasone is used as potential drug to reduce the severe inflammation against the caused by corona virus. This drug has shown positive effects against the Covid-19.

Background: Under the term "foreign bodies" of the upper digestive tract, it is conventional to consider food impactions and foreign bodies ingested accidentally or intentionally [1]. Intentional ingestions are most often sharp or stinging foreign bodies, or even “body packing” (plastic bags, most often condoms, filled with narcotics) [2]. We’re reporting our successful experience about endoscopic extraction of a "body packing” in a young patient of 27 years old. Keywords: Endoscopic Extraction Body Packing.

Despite the advent of generic drugs, many treatments still remain financially inaccessible to economically disadvantaged populations who constantly continue to turn to bioactive molecules from nature to find essential remedies that are gentle, more effective and with few side effects. Medicinal plants are still the primary reservoir of new drugs. The material used during this study consisted of plant material, animal material and technical material. 500 g of the sprayed plant drug was macerated in 2.5 L of distilled water for one duration of 48 hours. Numerous secondary metabolites of the aqueous extract of the leaves of Diospyros hoyleana F. White have been demonstrated. The acute oral toxicity experiment was conducted according to OECD protocol guideline 423. The mass of crude extract obtained after drying in an oven at 60 °C. was 64 g with a yield of 12.8%. Tests for Flavonoids, Saponins, Phenols, Tannins and Anthraquinones were found to be positive with the aqueous extract of the leaves of Diospyros hoyleana F. White while those for Alkaloids, Sterols, Terpenes and Coumarins were found to be Negative. After the acute oral toxicity study, no abnormalities of the physiological parameters observed in rats were observed. In addition, no deaths have been recorded. The LD50 was therefore greater than 5000 mg/kg. The body masses of the animals were generally increasing during the study regardless of the chosen batch. The rats were sacrificed and the masses of the internal organs were weighed. Four blood biochemical parameters of the groups of rats studied were assayed.

Background: The outbreak of Covid-19 is a new but one of the most intense pandemics in the world now. Although this disease is accountable for limited symptoms and complications like severe acute respiratory syndrome, fever, headache, diarrhea, malaise, and weakness, its probability of affecting people is very high. For this reason, its psychological and socio-economic impact demanded more attention from the world community. Aim of the study: The aim of this study was to evaluate the psychological and socio-economic impact of Covid 19 among the OPD patients in a tertiary care hospital in Bangladesh. Methods: This was a prospective interview-based study conducted in the Department of Medicine, Ibn Sina Specialized Hospital, and Dhaka, Bangladesh during the period from July 2020 to December 2020. In total 120 patients with several health problems, physically or virtually attended the OPD of the mentioned hospital were enrolled as the study population. The ethical committee of the mentioned hospital had been approved the studyl. All data were processed, analyzed, and disseminated by MS Office and SPSS version as needed. Result: In this study analyzing the negative impact of Covid 19 on the mental health of participants, we found feeling of suffocation, exhaustion, fear of falling ill, anxiety about the future, and feeling of loneliness were found as some major negative mental impacts on the respondents which were 11.67%, 10.83%, 8.33%, 7.5%, and 6.67%. Besides these, due to Covid 19 continuing, remote socialization, intolerance to others, random commitment violation, and ended social life were found 10%, 5.83%, 4.17%, and 1.67% participants respectively. In analyzing the negative impact on the economy of participants, we observed, the monthly family income was decreased up to 25%, 50%, 75%, and 100% of 21.67%, 12.50%, 5%, and 1.67% participants respectively. That means negative impact like decreasing monthly family income was found around 49%. Conclusion: Pandemic of Covid 19 is a new experience for the world community. The psychological and socio-economic impact of Covid 19 among patients as well as general people demanded more concentration now. Besides general people and patients, the whole economy and social structure of Bangladesh have already been affected by COVID-19. Unemployment and uncertainty of family income are responsible for secondary negative impact on the mental, physical health of general people as well as patients here. So, government policymakers, as well as world leaders, should be more conscious about these impacts and find out the proper way to resolve such pandemic.

Introduction: Cesarean delivery is increasing in both developed and developing countries. Though it is considered as a lifesaving surgical procedure for the pregnant women and the neonate, it has various risk factors and complications. Objective: The aim of this study was to assess the epidemiology and the results of the cesarean section in a single center of Bangladesh. Study Design: Retrospective observational study. Place and Duration of the study: The study was conducted in the department of Gynae & Obstetrics, Sher E Bangla Medical College Hospital, Barishal, Bangladesh, during the period from January 2019 to December2019. Methods: This is a retrospective observational study. Among the total number of cesarean patients, we recruited 75 women who were age 25-35 years with gestational age 37-42 weeks of pregnancy. Those who were less than 37 weeks of gestational age, the patients with multiple pregnancy complications, and those who were referred were excluded from the study. Written consent was taken. Collected data were compiled and analyzed using computer-based software, statistical package for social science (SPSS). Result: In this study, a total of 75 women who had a cesarean delivery were included. The baseline characteristics of the study people were: maximum 45(60.0%) study people were from the age group of 25-35, multipara was 54 (72.0%), and primipara was 21 (28.0%), most of the study people 39(52%) had normal BMI 10(25.3%) had overweight, 9(12.00%) had obese, 8(10.7%) had underweight. The majority 22(29.3%) of the study people were secondary educated. Most of the study people 37(49.3%) had 37-42 gestational age. The indications of cesarean delivery, 31 (41.3%) had repeat cesarean delivery, 12 (16.0%) had failed to progress, 9 (12.0%) had fetal distress, 8 (10.7%) breech presentation, 7 (9.3%) had antepartum hemorrhage, 6 (8.0%) had hypertension and 2 (2.7%) had diabetes mellitus. SAB was used in 61 (81.33%), pfannenstiel incision was used in 70 (93.3%), and the average operating time was 51.2 minutes. Subcuticular was mostly used 42(56%) for skin stitch followed by vertical mattress in 33(44.0%). Intraoperative antibiotic was used in 11 (14.7%), postoperative antibiotic was used in 9 (12.0%), both of these mentioned antibiotics were used in 6 (8.0%), and no antibiotic was used for 49 (65.3%). Conclusion: Repeat cesarean deliveries were found in most of the study people of the cesarean section. Surgical site infection was the most common complication.

The potentiality of yogic practices to improve physical and mental ability is well-known. The inclusion of yogic practice in cricket training protocol is a controversial topic. Plenty of research literature suggested that yogic asana improves physical fitness and controls competition pressure as well as match stress. So, the study was carried out to find out the effect of yogic practice schedule on cricket specific motor fitness. Thirty male district level cricketers with a mean age of 17.8 ± 1.6 years were selected and randomly divided into two equal groups. One group underwent through selected yogic asana practices along with their regular training and another group did not include yogic asana practice in their training schedule. Basic physical and physiological parameters along with some cricket specific motor fitness components were measured before and after four weeks of yogic practices. The basic physical appearances of two groups were merely similar and a low resting heart rate has been observed among cricketers. Four weeks of yogic practice significantly improved the muscle endurance, agility and balance. A positive effect has also been observed in the predicted V̇O2 max. The study revealed inclusion of yogic practice in training sessions for cricketers plays an important role to improve motor fitness which is a key factor of performance.

Introduction: Abnormal uterine bleeding (AUB) is the most common reason for gynecological visits for perimenopausal bleeding and may account for more than 25% of all hysterectomies. The perimenopause is often characterized by irregularities in the menstrual cycle in volume and frequency. This is due to fluctuating estrogen levels. These changes are unique for each woman and are unpredictable. Although irregular bleeding patterns are normal and expected to be part of perimenopause, the incidence of uterine pathology and associated medical complications increase in this age group [3]. The more accurate diagnosis of endometrial pathology better the chances for alternative treatment and hysterectomies could be avoided. The accuracy or the superiority of the relatively non-invasive methods like TVS, Hysteroscopy, and SIS over histopathology have not been clearly established. Thus this study was undertaken to compare the diagnostic efficiency of TVS over the histopathology study of the endometrium and to test their agreement. Materials & Methods: 48 cases of perimenopausal women above 40 yrs. age not yet attained menopause. Patient with AUB in any other age group, any vaginal or cervical cause of bleeding, Patient with blood dyscrasias, Pregnancy related causes of bleeding, Patient with h/o of drug intake (Anticoagulant & hormone replacement therapy) has been excluded. The cases were studied for a period of 11 months in Noble hospital & research Centre. Detailed history & clinical examination including per vaginal and per speculum examination carried out. All the patient then subjected to transvaginal ultrasound & endometrial sampling. Results were correlated between transvaginal ultrasound & histopathology in these patients. Results: In this study, 72.4% of women with normal endometrium had an endometrial thickness of less than 12mm below which there was no endometrial pathology. Above this cut off level of 12mm, 88.6 % were found to be associated with endometrial pathology. The sensitivity and specificity were found to be 61.9% and 77.8%. Distribution of histopathology findings differ significantly between groups of cases with less than 12mm and more than 12 mm endometrial thickness (P-value < 0.048). Conclusion: Transvaginal sonogram is a simple, non-invasive convenient way to indirectly visualize the endometrium & endometrial cavity. The vaginal probe examination if incorporated into the gynecologist office setting and when combined with bimanual pelvic examination can enhance our anatomic diagnosis. Transvaginal sonography is useful as a first step diagnostic procedure in the evaluation of perimenopausal bleeding. When combined with dilatation and curettage it can supplement the shortcomings of dilatation and curettage.

Aims: Include determining the prevalence of hypertension in UPTH from January 2017 to December 2019, to describe the risk factors associated with hypertension, to describe the demographic distribution of patients with hypertension and to determine the outcome of hypertension in UPTH. Study design: The study is a descriptive cross-sectional study. Place and Duration of Study: The research was carried out at the University of Port Harcourt Teaching Hospital between January and June, 2020. Methodology: A multi-stage random sampling method was used in selecting the records of all patients admitted to the medical wards of the UPTH (between January 2017 – December 2019), with essential hypertension. The first stage involved the use of disproportionate sampling method (where each of the years, 2017-2019 constituted a stratum) to select all the hypertensive cases admitted in each of the years. Simple random sampling was then used in the second stage to select 70 samples from each year, to make up the 210 sample size. This was generated through the use of random numbers. The data were analyzed manually by sorting, tallying and collated into data sheet. Both descriptive and inferential statistics were used to analyze the data. Results: There were a total of 3,200 medical admissions during the period under review (2017-2019), and the prevalence of hypertension was 16.8% (537).The records of 210 (6.6%) hypertensive patients were reviewed and analyzed. There were 109 (51.9%) males and 101 (48.1%) females with a male: female predilection of 1.1:1. The mean age was 55.7 ± 4.5 years with a mode of 62 years. Urban dwellers were 63.3% while 36.7% were rural dwellers. Also, 57.1% of these patients were in social class V (unskilled workers, farmers, traders and housewives); and only 2.9% in social class I (professionals). More so, chronic alcohol intake accounted for 16.7% of the admitted cases, followed by diabetes mellitus with 12.4%.Smoking and obesity were 1.9% each. Heart failure was the commonest complication of hypertension (39.5%), while stroke was the commonest cause of fatality (25.0%). Conclusion: Hypertension is an important health problem in the world over. Hence emphasis should be placed on the primary prevention of hypertension through intensive campaigns on lifestyle modifications and regular blood pressure checks. In addition, efficient record keeping and the establishment of a stroke registry would help in the management of hypertension.

Objectives: To assess the feasibility of self mouth examination (SME) in case finding of oral cancers and potentially malignant disorders (OPMD) among high risk rural population in India. Materials and methods: 15,000 pretested pictorial handout (brochure) with instructions (local language) depicting the signs of oral cancer and self mouth examination procedures were distributed among every households (n= 3500), People were also demonstrated self mouth examination (SME) technique. One week later a three day cancer detection camp was carried out. Individuals were instructed to conduct self mouth examination (SME) and report the cancer detection camp if any questionable lesions were noticed. Individuals who reported were screened for oral cancer with the use of toluidine blue vital staining, oral exfoliative cytology and final diagnosis through biopsy. Results: The total population consisted on 579 individuals out of which 372 (64.25%) were males and 207 (35.75) were females. The total percentage of self mouth examination (SME) performance was 95.34%. 53.20% of the study population identified suspicious lesions in the oral cavity. After thorough oral examination, malignant lesions like oral cancer (2 cases) and many cases of oral potentially malignant disorders were found. The sensitivity of mouth self examination was 48.66% where as the specificity was 44.75%. The positive predictive value was 23.54% where as the negative predictive value was 71.37%. Conclusions: Self mouth examination is an effective tool which can be used in the case finding of oral cancers and oral potentially malignant disorders.

Wannan bincike da aka aiwatar a kan Maƙwabtakar Hausawa ya mayar da hankali ne ga duban irin tunanin Bahaushe dangane da abin da maƙwabtakarsa ta ƙunsa wanda ake tunanin ya ƙara bambanta shi da saura al’ummu na duniya. An gudanar da nazarin ne domin duniya ta fahimci cewa, zaman muhallin Hausawa kusa da juna yana ƙunshe da wasu hikimomi da tanade-tanade da suke da alaƙa da kyakkyawar rayuwar mutanen. A ƙoƙarin tattara bayanan da suka gina wannan maƙala an nazarci irin cuɗanyar da Hausawa suka yi da juna a birane da ƙauyuka musamman a dauri ta yadda zai bayar da hoton ainihin abin da maƙwabtakarsu ta ƙunsa. Haka kuma an yi mu’amala da mutanen da suka fahimci zamantakewar Hausawa da hikimomin da ta ƙunsa. An bibiyi yadda zamantakewar Hausawa take a yanzu a wasu sassa na birane da ƙauyuka inda ake ganin har yanzu akwai wannan tunani a zukatan mutane. A ƙarshen wannan nazari an fahinci cewa, Bahaushe yana ɗaukar maƙwabcinsa kamar ɗan’uwansa na jini. Abubuwan da Bahaushe ya ɗauka maƙwabtakar su ne taimakon juna da kyakkyawar fata a tsakanin mutanen da muhallansu suke kusa da juna. Wannan tunani na Hausawa an fahimci bai tsaya ga magidantan da suka mallaki muhallin ba. Hatta da matan aure da yara ƙanana suna tafiya a kan wannan tunani da kuma tsari. Binciken ya tabbatar da maƙwabtakar Hausawa ta ƙunshi ɗabi’a mai kyau wadda ta taimaka musu wajen samar da zaman lafiya da rayuwa mai inganci.

Cervical ectopic pregnancy is a rare form of ectopic pregnancy with implantation of fertilized ovum in the cervical canal below the internal os. Incidence of cervical pregnancy varies 1:1000-95000 and associated with high maternal morbidity and mortality due to high chances of pregnancy being misdiagnosed. To reduce maternal mortality, it is indeed necessary to understand the importance of correct diagnosis by clinical or radiological or biochemical methods available. Here we present a case of a 36-year-old female reported to us in Noble hospital as a misdiagnosed case of cervical ectopic pregnancy with catastrophic bleeding. Management of the cervical ectopic pregnancy is dependent on several factors such as the patient's gestational age, fetal cardiac activity, stability of the patient, patient's interest in retaining future fertility, and the availability of resources and expertise of the practicing gynaecologist. The cervical ectopic pregnancies though rare, do occur, and their incidence is increasing. A high index of suspicion, clinical and radiological correlation, especially in cases with previous uterine scars can pick up this rare entity preoperatively. If diagnosed early conservative management can be offered. However, missed diagnosis can lead to high morbidity and mortality.