COVID-19 has become one of the worst infectious disease outbreaks of recent times, with over 6.3 million cases and 367000 deaths. Our study aims to analyze characteristics, biomarkers changes of patients with COVID-19 and their associations with severity and outcomes of the disease. Laboratory parameters included inflammatory markers such as procalcitonin (PCT), serum ferritin, C-reactive protein (CRP), lactate dehydrogenase (LDH) and interleukin-6 (IL-6). Fifty-two consecutive hospitalized patients in intensive care unit with confirmed COVID-19, in the university Hospital of Mohammed 6 of Marrakech were enrolled in this retrospective study between March 20, 2020, and May20, 2020. Demographics, underlying diseases and laboratory data were collected. 39 (75%) were man and 13 (25%) were woman; the mean age was 58 years, 76, 1% were up to 50 years old. Among all non-survivors, 81% were male. The median course of the disease was 9 days. The most common co morbidity was hypertension (13/52, 25 %) and diabetes (13/52, 25%). Respirator was used in 23 patients (23/52, 44.2%). 78.59% patients had received Hydroxychloroquine+Azythromycine and 15.8% patients had received antiviral medications: lopinavir/ritonavir. The fatality rate was 71.2 % in this population considered critical. On admission, regardless of the severity, majority of patients present an identical level of inflammation marker levels. Levels of serum ferritin (median 845 [IQR 102.5–4275]), CRP (median 174.15 [IQR 5.19–508.39]), PCT (median 0.68 [IQR 0.04– 45]), LDH (median 519.5 [90–1238]), IL6 concerning 7/52 (median 101[IQR 17– 201]. Dynamic changes of biochemical and immunologic biomarkers during progression of COVID-19 across on admission, mid-hospitalization and end-hospitalization. Measurement of inflammatory markers especially CRP, IL-6 and serum ferritin might assist clinicians to evaluate the severity of COVID-19 because the variations of these biomarkers could serve to predict recovery of fatal outcome.

Nanotechnology playing significant role in different fields of sciences as the multidisciplinary particularly physics, chemistry, biology as well as in biomedical sciences. There are different types of nanoparticles depends upon on the particular metals and their function at cellular level. The most important nanoparticles are the carbon based, zinc and silver. Silver nanoparticles can be synthesized from silver nitrate as the main starting agent with sufficient quantity. One of the most important of synthesis of nanoparticles through green synthesis approach that are environment friendly. Through polysaccharides method, silver nanoparticles can be synthesized through the biological agent such as polysaccharides that particularly replaying impregnate role in characterization of nanoparticles in the presence of water. C. vulgaris as the active biological organism untitled for the production of silver nanoparticles at the normal room temperature. soluble polyoxometalates are capable of synthesizing noble nanoparticles through stepwise, multi-electron redox reactions inertly. TEM is a very powerful technique for the characterization of NP size, composition and crystalline structure. X-ray diffraction (XRD) is one of the most extensively used techniques for the characterization of NPs. Clay nanoparticles are playing important in textile industry to assist in making the long chain of fibers.

Tourism promotion activities have become an extremely effective tool to attract and persuade visitors to tourist destinations, which is a very essential factor in promoting tourism development. Therefore, tourism promotion is becoming a hot issue in tourism development in today's destinations. Because of the fact that in developed countries, tourism has been quite successful thanks to tourism promotion activities, contributing to the better development of the tourism industry. The promotion of tourism is considered as one of the key tasks of Vietnam's tourism in general and the tourism of provinces and cities in the country in particular. This study clearly shows the role and importance of tourism promotion law in promoting tourism development through the practice of Binh Duong province; from there, proposing solutions to improve this law.

Nurses are the vital part of the health care departments and there is no doubt that nurses are the prime unit of the health care profession. According the world health statistics analysis there are approximately 29 million nurses worldwide and there is an estimation that one million nurses are further needed by the year of (2020) Shortage of nurses affect the country health care setting and significantly, it also affect the patient care which results in overall health decline in the whole country. Pakistan is also facing great challenges regarding the nursing profession and shortage of nurses is at the top of these challenges and nursing profession is female dominated profession which also increases the social cultural boundaries. As per results of a research conducting regarding Pakistan nursing work in overcoming the shortage of the nurses in the Pakistan as it is a big challenge faced by the Pakistan in the last decay. I feel very disappointment that in Pakistan this profession faces more problems/ shortage of nurses as compare to other countries. The facts and figures related to the health care in Pakistan are alarming and to handle these the health care provider and the government of Pakistan should take the strong steps. Due to this shortage patient care effects. The nursing workforce in Pakistan is 4.9: 10,000 (WHO, 2016) which indicates a shortage for a country with population of about 193 million (WHO, 2019). Unluckily, the education role of the nurses in Pakistan is not improper shape as it should be only good nurses can be produce by the good educator nurses. In the past nursing care was limited to the bedside patient care but now a days nursing research and advance studies have opened new horizons for the nurses in the country .

Background: The micronutrient folate and zinc has been associated with semen quality. Nutritional supplement with zinc and folate can help reverse some of the oxidative damage from environmental toxin and natural aging on spermatogenesis and sperm maturation. Till now there has been variable results in the research done on semen quality after folic acid and zinc sulfate supplementation. The objective of this study is to determine whether supplementation of folic acid and zinc sulfate has any beneficial effect on semen quality. Methods: This was a prospective, observational study carried out in the Department of Reproductive Endocrinology and Infertility, Bangabandhu Sheikh Mujib Medical University. Study participants are male partners of infertile couples, 70 in number, who attended the outpatient department and had abnormal semen parameters. Supplementation of folic acid and zinc sulfate was given to all male partners at a dose of 5mg tablet twice daily and 10mg tablet twice daily respectively for twelve weeks. Semen analysis was repeated after the period of three months supplementation of folic acid and zinc sulfate. Paired students t tests were performed for test of significance. Results: Oligoasthenoteratozoospermia is most common (40%) form of abnormality in semen parameter before supplementation. After supplementation 40% of report shows normozoospermia. Following supplementation of folic acid and zinc sulfate there was significant changes in sperm count (P<0.05), morphology (P<0.002), total motility (P<0.001). Regarding motility, all types of motility improved after supplementation including rapid-linear (P<0.001), slow linear (P<0.001), non-progressive (P<0.047). Number of immotile cell was reduced (P<0.001) after supplementation. Conclusion: An improvement in nutrition or supplementation with zinc and folate can have noticeable effects on semen quality and these may improve natural fertility and success rates with fertility treatment.

Nurses in all part and site can establish leadership in contaminating prevention and control using the knowledge skills and site judgment to initiate proper and immediate infection control nurses play a very important role in infection control. Health care professionals in certain are often showing to several infections healing their daily work nurses have complete awareness and infection control practice. All health care workers whose responsibility to protect the patients from getting infection in hospital and other health care center. Keeping an infection free setting patient’s recovery will be promoted and provide the great quality of care. Nurses can do a great agreement to communicate effectively e.g. Nurses should provide the information charge nurses visitors and patient. Provide the proper information patient how to protect themself including support staff in team. Nurses contribution in this war against infection control using the barrier precaution like face marks caps gowns and gloves. Infection control and prevention practices minimize the infection to apply the patient care use the standard Precautions the practices are protect and prevent to spread infections among patients and healthworker and nurses. Frequently hand washing, use of proper personal protective measures sharp safety respiratory care and hygiene good practices of safe injection and use the sterilized instruments. Nightingale mentioned the person as a patient. Atmosphere affects the person. Better atmosphere help to heal the patient soon as compared to polluted. Health is the complete well-being not only to be well. Good environment provide healthy life and prevent the disease.

With increasing time the movement, velocity and acceleration of mold will become sinusoidal wave. When the crank length increases from 40mm to 70mm under linkage length L=160mm the maximum movement, velocity and acceleration will increase and the minimum ones will increase. The phase angle will decline with inclining rotation with sinusoidal wave but the size of them maintains unchanged respectively. So it is chosen of the short crank and long linkage so as to maintain maximum force. To be rapid work the rotation is needed highly.

Objective: The aim of this research was to ascertain how often blood donors were VDRL seropositive and whether there was a connection between syphilis serological evidence and age as well as residency. Methods: A retrospective analysis of sequentially blood donor documents from January to December 2019 was performed out in North Darfur State, Western Sudan. The analytical descriptions wre computed using percentages. Chi-square was used to analyze trends and quantify p-values. Results: There were a total of 6100 enthusiastic blood donors, all of whom were males between the ages of 15 and 55; the average age was 29.5 years. VDRL screenings for syphilis indicated that 794 of them (13.0 %) had serological evidence of syphilis, and the remainder 50306 (78%) were negative. A strong association was found between residency and serological evidence of syphilis infection in the study (P = 0.000). Age was shown to be a strong predictor of the occurrence of transfusion transmissible infections (P = 0.002). When opposed towards the other age categories, the (21-25) and (26-30) year age ranges had a higher incidence. 239/1551 (15.4%), 140/1089(12.8%) were positive respectively. Conclusions: There seems to be an increasing proportion of sero-positive VDRL in blood donations in North Darfur State. An association between syphilis infection and residency was realized, as well as a high prevalence within a particular age demographic with a statistically meaningful correlation.

Background: Aged women who have infrequent menstruation and raised FSH are likely to have diminished ovarian reserve. Serum AMH is a novel marker of ovarian reserve but the test is expensive. The objective of this study is to determine serum AMH level in women who have high FSH and see how AMH and FSH correlate in this group of women. Methods: We did an observational cross sectional study of 87 infertile women, age 30-39 years, with oligomenorrhoea and high FSH (>10IU/L). Serum FSH was measured on day 2-4 and AMH was measured on any day of menstrual cycle. The women were divided into three groups based on FSH: 10-20 mIU/mL, 21-40 mIU/mL and >40 mIU/mL. Correlation of AMH with FSH was analyzed in all participants as well as within different groups. Results: The mean serum FSH D(2-4) was found 38.8±22.4 mIU/ml, range (min-max) (10.2-93.5) mIU/mL. Not all but 85.1% women had low (≤1.0 ng/ml) serum AMH level. Mean serum AMH was 0.74±0.59 ng/mL, range (min-max) (0.90-2.9 ng/ml). The serum AMH decreased in groups with higher FSH. The one way ANOVA shows that there is significant difference in AMH values between the groups. There is moderate (r = -- 0.537) negative correlation of AMH with FSH. The negative correlation of AMH with FSH is strongest (r = - 0.735) in the group having FSH in the range 10-20mIU/mL. The correlation is comparatively less (r = - 0.519, r = - 0.616) in groups with higher FSH. Conclusion: Not all the sub-fertile women with infrequent menstruation and FSH>10 mIU/mL have lower AMH (<1 mg/ml). A significant negative moderate correlation exist between AMH and FSH. The correlation is relatively stronger in the FSH range 10-20 mIU/mL.

The purpose of this research was to determine and analyze the effect of financial performance on devidend policy and its implications for corporate value in the construction and building industry sub-sector listed on the Indonesia Stock Exchange for the years 2014-2019. The population was 18 companies and sampling technique is purposive sampling, so that the sample in this study amounted to 8 companies. The data analysis technique used is multiple linear regression analysis with the help of Eviews Statistic application. The results of this research indicate that Cash Ratio has a negative not significant effect on DPR. DER has a positive not significant effect on DPR. ROA has a negative significant effect on DPR, while RTO has a negative not significant effect on DPR, and DPR has an effect negative not significant on Tobin’s Q.

The objective of this work is to clarify by a retrospective study the prognostic parameters of breast cancer in young Moroccan women and to clarify the epidemiological histological and prognostic characteristics in a subgroup that have a metastatic relapse in order to determine the impact of the diferent prognostic factor on overall survival. During a period of 5 years, from January 2010 to December 2015, 325 women suffering from breast cancer were counted at the Radiotherapy Department of the Mohammed V Military Hospital of Instruction. Among them, 60 were aged 40 years and under. In our series, patients were followed up until April 2018, 13 cases of metastatic relapses were recorded, i.e. 21.7% of cases. In a single-factor study, the prognostic parameters were mean consultation time, age, family history of breast cancer, tumor size, histological type, number of lymph nodes invaded, lymphatic embolism, SBR grade, hormone receptor, and herecept-test status. The overall survival rate of all patients was 92,1% at 3 years and 88,9% at 5 years. Multifactorial analysis isolated 3 prognostic parameters: initial tumor size, the number of lymphaitic gonglion invaded and the molecular type.

Background: Miscarriage is the most common negative outcome in pregnancy worldwide. Its identification of modifiable risk factors is playing an important role in public health. Low vitamin D concentrations in pregnancy are widespread worldwide and the effects of vitamin D deficiency in pregnancy have been associated with some adverse pregnancy outcomes. We have very limited research-oriented information regarding the correlation between serum vitamin D deficiency and early spontaneous pregnancy loss. Aim of the study: The aim of this study was to evaluate the association of maternal serum vitamin D deficiency with early spontaneous pregnancy loss. Methods & Materials: This case-control study was carried out in the Department of Obstetrics and Gynaecology, Sir Salimullah Medical College and Mitford Hospital, Dhaka, Bangladesh during the period from September 2018 to August 2019. A total of 100 patients, 50 pregnant women having early spontaneous pregnancy loss (documented by ultrasonography as missed or incomplete abortion) was considered as the case (Group I). Age, gestational age and BMI matched another 50 women in their early live pregnancy (documented by ultrasonography) was served as control (Group II) in this study. The biochemical parameter measured in this study included fasting serum 25-hydroxy vitamin D level. Serum 25(OH)D level<20 ng/ml was classified as vitamin D deficiency and <10 ng/ml was classified as vitamin D severe deficiency. Statistical analyses of the results were obtained by using window-based computer software devised with SPSS version 22.0. Results: In analyzing vitamin D level (ng/ml) of the participants of this study it was found that more than half (52.0%) patients had severe deficiency (<10 ng/ml) in group I and 14(28.0%) patients in group II. 24(48.0%) patients had deficiency (10-20 ng/ml) in group I and 35(70.0%) in group II. Only 1(2.0%) patient had insufficiency (21-29 ng/ml) in group II. None of the patients had sufficient serum vitamin D levels. In comparing the serum vitamin D level (ng/ml) between group I and group II it was observed that the mean vitamin D level was 9.98±2.56 ng/ml in group I and 11.51±2.96 ng/ml in group II. The difference was statistically significant (p<0.05) between the two groups. Conclusion: Serum Vitamin D was significantly low in women with early spontaneous pregnancy loss as compared to pregnant women with early live pregnancy. Serum Vitamin D was deficient predominantly in both cases and control. Maternal serum vitamin D deficiency was significantly associated with early spontaneous pregnancy loss.

Thyroid diseases are a common endocrine disorder, and thyroid hormones physiologically are well-known to have direct and indirect effects on metabolic abnormalities. Disorders of carbohydrates (glucose) metabolism are frequently reported in both hypothyroidism and hyperthyroidism. This review considered to examine and analyze the role of thyroid hormones and their abnormalities in different level of glucose metabolism in intestinal and liver cells. A broad literature search been performed on Google Scholar and PubMed for the periods between 01/01/2021 and 25/03/2021. The search includes the followings key words; thyroid hormones, glucose metabolism, hepatocytes, hypothyroidism, hyperthyroidism, thyroid receptors. Liver represents a major organ that involves in both consumption, storage and production of glucose. The expression of thyroid hormones receptors in the hepatocytes are often recoded. Thyroid hormones facilitate glucose absorption from gastrointestinal system. In hyperthyroidism, hepatic glucose intake, glucokinase activity, mitochondrial activity and biogenesis, gluconeogenesis, glycogenolysis and hepatic glucose production all shown to increase. In hypothyroidism, intestinal Glucose Absorption, GLUT2 expression in hepatocytes, hepatic glucose intake, glucokinase activity, mitochondrial activity and biogenesis, gluconeogenesis, glycogenolysis are all seeming to reduced. In conclusion; Thyroid hormones represents a major regulator of glucose metabolism, and achieve their effects through promotion or demotion of expression or activation of enzymes responsible for regulation of different metabolic pathways. Thyroid disorders is associated with abnormal metabolism that could disturb the metabolic pathways and contributes or exacerbate other concomitant disease such as diabetes and metabolic syndrome.

The implementation of regional development in order to be carried out as expected, one of the influencing factors is the preparation of a financial budget in financing any regional development because without adequate financial budgeting, both in the form of revenue targets and realization of regional expenditures, financial management in the form of revenue and regional financial expenditures will not be implemented effectively. There are many efforts that can be made by local governments in improving people's welfare, one of which is the equitable distribution of development in a more just and balanced manner in each region. After conducting the research, the authors obtained the research results that in 2017, 73.20% was categorized as less effective, in 2018 50.95% was categorized as ineffective, and in 2019 54.26% was categorized as ineffective. These three years show that the financial performance of the Enrekang Regency Government has decreased, for the efficient value in 2017 of 11.51%, in 2018 it was 18.88%, and in 2019 it was 19.44%. During these three years, it shows that the regional financial performance is in the very efficient category.

Background: Long term abstinence from smoking is the objective of tobacco cessation therapy. Varenicline, FDA approved a novel beta 4 alpha 2 nAChR partial agonist may offer more benefits. Objectives: To assess the effectiveness and evidence of varenicline over nicotine replacement therapy in extended term abstinence to smoking. Search strategy: A systemic literature survey was carried out identify in electronic database such as PubMed, MEDLINE; Database of Reviews of Effects (DARE); in English language using MeSH terms ‘Varenicline’ ‘Nicotine Replacement Therapy’ ‘Abstinence’ of last 10 years from 2008 to 2020. Selection criteria: We included randomized controlled trials which compared Varenicline when compared with NRT. Results: Initially 182 articles were filtered out, selection of 7 articles by independent reviewer were done. Data from each study were extracted by one reviewer and independently checked for accuracy by a second reviewer. At two years, 28.8% of participants who were prescribed varenicline and 24.3 percent of those who were prescribed NRT quit; the adjusted odds ratio was 1.26 [95 percent confidence interval (CI): 1.23 to1.29], P 0.0001. At 24 weeks, the RR for varenicline versus NRT for abstinence was 1.25. (95 percent CI 1.14 to 1.37; 8 trials, 6264 people; moderate-quality evidence). Conclusions: An 8-week course of varenicline tends to result in a higher rate of abstinence for up to three years than a similar course of NRT in clinical practice.