Background: ACS is a major cause of mortality and morbidity in both developed and developing countries. HsCRP is an independent risk marker of cardiovascular disease. Objective: The aim of this study was to compare serum hsCRP levels and lipid profile and to correlate with angiographic findings. Materials and methods: This is a case control study, 70 patients with onset of chest pain and 70 sex matched controls were enrolled. Details of clinical examination, ECG, angiographic findings and laboratory findings like CK-MB, AST, LDH also collected. RESULTS: Among the cases, highest mean levels of hs-CRP, CK-MB and LDH were found in STEMI patients compared to other two groups. Among the 28 UA patients 21 were diabetic (75%), in the case of STEMI it was 79%, 19 out of 24, and in the case of NSTEMI 12 out 18 (67%). Patients with SVD, had hs-CRP levels <1-3 mg/L whereas most of the patients with TVD had elevated (>3 mg/L) hs-CRP level. Conclusion: The present study showed a positive correlation between hsCRP, dyslipidemia and angiographic findings in ACS. Hs-CRP seems to be a stronger predictor of cardio vascular events.

The purpose of this study was to determine the effect of electronic word of mouth and sales promotion on brand switching with brand image as an intervening variable at the ERHA Beauty Clinic in Samarinda City. The study was conducted using 115 respondents. The analysis tool used is SmartPLS 3. Data analysis is carried out by assessing the outer model or measurement model and assessing the inner model or structural model. The results showed that electronic word of mouth and sales promotion partially had a significant positive effect on brand switching, and electronic word of mouth and sales promotion had a significant positive effect on brand switching through the brand image variable as an intervening variable.

Introduction: Literature revealed many studies were concerned with the ideal timing of skeletal discrepancies treatment regardless the type of appliance used. Aim: This study aimed to investigate perspective of orthodontists toward ideal timing for different treatment procedures with functional appliances and explore their association with the demographic background in Saudi-based offices. Materials and methods: In this observational analytical cross-sectional study a web-based questionnaire was distributed among members of the Saudi Orthodontic Society. Questionnaire involved background questions and closed-ended questions regarding timing of treatment, protocol of approaching, and length of treatment with functional appliances. Data analyzed in frequency tables and the use of association tests with significant level of p<0.05. Results: One hundred and four orthodontists (65% males, 35% females) completed the distributed questionnaire. Over 50% of orthodontists preferred to align the dentition after functional treatment. Majority (81.7%) preferred functional treatment of Class II deformities at the stage of late mixed dentition. Orthodontists were about equally divided in their management in terms of the phases of Class II treatment. Orthodontists revealed a high preference rate for early intervention by functional appliances during both stages of deciduous and early mixed dentition (81.8%). Accordingly, their treatment was usually pursued in two phases. The length of treatment with functional appliances in Class II cases was mainly preferred in the range of 7 to 12 months (61.5%) while in Class III a dominant preference for the period of 7 to 18 months of treatment (74%). Conclusion: Orthodontists’ training background was strongly associated with many treatment decisions using functional appliances especially in management of Class II cases.

The occurrence of hemorrhage from an intra-arterial catheter remains exceptional despite the risk of disconnection described for the femoral site. The occurrence of a state of hemorrhagic shock on the arterial blood pressure line still remains accidental and may be responsible for high morbidity and mortality. We report a case of hemorrhagic shock that occurred in intensive care following an accidental disconnection in the blood pressure system.

Based on local government medium term expenditure framework (MTEF) model, financial accountability results is a continuous set of activities and operations related with provision of goods and services to customers and benefits accumulated from payments of goods and services. The purpose of study was to analyze the effects of revenue collection on financial accountability of Rorya District Council in Tanzania. The specific objective was to analyze the effect of cess collection on financial accountability in Districts Council in Tanzania. The study used cross-sectional survey research design. The target population of 760 Rorya District council members was used. Stratified sampling technique was used to determine the sample size of 288 respondents. Closed ended questionnaire was used to collect primary data arranged using 5 point scale likert scale. Descriptive statistics was used to analyze data and inferential to make inferences. The result was presented by tables and figures. The study found that cess collection was from fishing (Sangara) and was well achieved. The study recommended that cess collection revenues should be improved by the set target compatible with all customer fees. Further, the study recommends further research can be done on the impact of revenue collections in rural and urban local authorities in developing countries.

In India, hyperthyroidism accounts for 5 per 10,000. The seriousness of thyroid disorders should not be underestimated as thyroid storm, thyrotoxicosis and myxedema coma can lead to death in a significant number of cases. In this study, 50 female patients of above 18-year-old were included in the study (Pre- and Post-menopausal), whereas patients who have undergone radioactive ablation and thyroidectomy were excluded. Blood samples were collected and thyroid tests like TSH, T3, T4 were performed by the method of chemiluminescence enzyme immunoassay. Complete Blood Count (CBC) is performed to check the values of Hb, RBC, WBC, Neutrophil, Basophil, Eosinophil, Platelet, Lymphocyte. Liver function tests like SGOT and SGPT were performed to find whether carbimazole induces any liver damage. Thyroid tests and CBC values were noted down at the time of diagnosis and during the course of treatment. Out of 50 hyperthyroidism patients, 2 patients (%) experienced Neutropenia and Agranulocytosis. According to a study done by Davies [6] Carbimazole shows rare adverse effects like neutropenia and agranulocytosis. In our study, 2 patients (6.8%) experienced neutropenia and agranulocytosis. They have symptoms like blisters in mouth and fever. When their CBC were done, it was found that their neutrophil count and WBC has reduced. When neutrophil count is reduced, body’s ability to fight off foreign body reduces and it ensures easy attack by micro-organism.

This research work seeks to explore the capitals utilization for livelihoods among households with People Living with HIV/AIDS (PLWHA) in Kaduna State, North West, Nigeria. The study adopts a qualitative procedural and explicitly phenomenological in nature and employed in-depth interviews, participatory and non-participatory observations as research tool. The interview period of conducting the fieldwork was from August to November, 2019 and twenty-one households with PLWHA in Kaduna State, North West, Nigeria were utilized as the qualified target. This research results discovered that households with PLWHA utilized a range of capitals for their livelihoods and created their livelihoods patterns based on their available capitals. The findings revealed that there are five types of capitals as resources utilized by households with PLWHA to fashioning out their livelihoods patterns and such capitals are social capital for resolving households difficulties and participating in the villages activities; financial capital utilized by households for investments and land accretions; human capital like knowledge and know-how useful in their line of businesses to maintain their households; natural and physical capitals that are utilized as means to make every effort to make living like cutting trees for cooking and selling, collecting of herbs from the forest for medication, road network among other things. Based on the findings of this study, it is recommended that authorities need to train households with PLWHA on how to enhance their capacities on livelihoods capitals utilization effectively. The government should come up with policies that can take care and support the livelihood hood activities of households with PLWHA.

Introduction: Mantra: In its most rudimentary form, a mantra is made of syllables which exert their influence by means of sound (vibrations). As one would have personally experienced, different syllables have different vibration patterns which affect different parts of the body. Material and Methods: This is prospective and observational study. Inclusion Criteria: Males and females with Age group 20–30 years old. Exclusion Criteria: Significant cardiovascular and respiratory systems complications, Thyroid disorders, Uncontrolled diabetes mellitus, Addiction to alcohol and Smoker. Results: In the pre-intervention, study group had a mean HR value of 73.46±2.78, which has been decreased to 67.36±2.66 in the post intervention, which was found to be highly significant (P=<0.003). Similarly, the control group had a mean HR value of 74.12±2.35 which has been decreased to 73.24±3.21, the decrease was not statistically significant (P=0.064). In the post intervention, study group had a mean heart rate (67.36±2.66) and control group had a mean heart rate (73.24±3.21) the change in the HR in the two groups differed. Whereas study group had greater decrease in HR compared to control group. Which was found to be highly significant (P=0.002). Conclusion: To summarize, our study demonstrates that pranayama practice is effective in reducing perceived stress but significant benefit on physiological parameters is seen in only study subjects practicing pranayama.

Mullerian anomalies cannot always be defined in one or the other class, as described by the American Society of Reproductive Medicine. One such unclassified anomaly incidentally found in a infertile women with polycystic ovary syndrome, was difficult to diagnose with existing imaging modalities. The final diagnosis was not made until after the surgeries including diagnostic laparoscopy and hysteroscopy.

Aim and Background of the study: Subfertility is an intricate health problem which is rising dramatically. Patient’s demographic factors along with pelvic pathology significantly important for uprising trend. The aim of this study was to evaluate the demographic and clinical characteristics of patients with infertility specially identifying the ovulatory disturbance, tubal factors, pelvic adhesion and endometriosis by Laparoscopy. Methods: This retrospective study was conducted in infertility clinic of BIRDEM hospital, Dhaka, Bangladesh from May, 2007 to October 2007. The sample size was 100.Result: In this study, among 100 patients 68% had primary and 32% had secondary infertility. 55.9% were within 20 to 30 years age group and 44.1% above 30 years age in primary subfertility. 21.9% were within 20 to 30 years age group and 78.1% above 30 years age group in case secondary subfertility. 58% patients were house wife. 42% of patients were service holder they were teacher and other professional personnel. In this study majority (77%) of patients are from upper-middle class and middle class family. Out of all patients of primary infertility 58.8% had regular, 44.2% had irregular cycle 30% had scanty, 20% had menorrhagia and 29.4% had dysmenorrhea. Within secondary infertility group 87.5% had regular, 12.5% had irregular cycle 25% had scanty, 21.4% had menorrhagia and 75% had dysmenorrhea. In laparoscopy majority (55.0%) had normal ovary, 20.0% had cystic change with thick capsule in right ovary and 22% had in left ovary, 7.0% had endometriosis, 8.0% had adhesion, 10.0% had simple cyst in right ovary and 8% had in left ovary and rest could not be visualized. 79.4%right & 77.9% left fallopian tube patent in primary subfertility cases and 56.3% right & 59.4% left tube normal in secondary subfertility cases. Both fallopian tube patent in 62%, unilateral block 21% and bilateral block in 17% cases. In this study peritoneum was normal in 78% cases, 8% cases there was endometriosis and 14% cases there was adhesion of fallopian tube with the ovary, adhesion of uterus with intestine and also with bladder. In this study, Pouch of Douglas was normal in 77% cases, 7% had endometriotic deposits 16% had adhesion and obliteration of Pouch of Douglas. In this study 74% of patient had normal size of uterus, 3% had uterus smaller than normal size and 23% had bulky uterus. 83% patient had freely mobile uterus and rest had restricted mobility. Conclusion: From analyzing the findings, we recommend that awareness developing program about the factors affecting infertility should be taken. Laparoscopy is more convenient, conclusive & more precise for diagnosing the cause of subfertility. Early diagnosis and treatment should be encouraged among couple.

Senegal has been plunged in resolving the health crisis of the COVID-19 pandemic since its appearance in March 2019 on Senegalese territory. All useful means such as communication are pointed up to cut the line of contagion of the virus. In this communication fight against the COVID-19 pandemic, we noted the presence and use of concepts, slogans and / or “sloganized” expressions of which understanding of their communicative values requires an operation of interpretation and decoding. The perception of the informative content of such speech acts is based on their context of use by the communicating subjects. In the pragmatic theory of language where the communicational approach is based on fundamental notions: the implied and the presupposed, the interpretation of the communicative value is done through a set of values, common to the communicating subjects, which guarantees the intercomprehension of messages. This article aims, from a pragmatic and enunciative angle, to enumerate the slogans and concepts created in the management of the pandemic and then to identify their new semantic particularities, and to decipher their preventive implicit content in the communication of the fight against COVID-19. Particularities that are similar to calls for awareness on the existence and seriousness of the disease.

Scholars carrying heavy backpacks incur misaligned vertebral posture and neuro-musculoskeletal discomfort and pain. This report intends to determine whether there is a compensatory inverse relationship between standing anterior pelvic tilt (SAPT) and craniovertebral angles (CVA) when heavy backpacks are carried. A male pubescent carried a backpack weighing 6.2kg (17.3% of his body mass) over both shoulders resting against his vertebral column. The pubescent CVA, SAPT, standing vertex height (SVH) was measure during unloaded, and three loaded phases. Each loaded phase approximately increased from 10%, 20% and 30% of the pubescent’s relative body mass. The incremental backpack masses reduced the SVH and increased the SAPT, while simultaneously reducing CVA. There was a positive relationship between increased backpack mass and SAPT (r=+0.9). Craniovertebral angle inversely attenuated in response to the heavy backpack loads (r=-0.9). These findings indicate that there is an inverse compensatory relationship between SAPT and CVA when carrying heavy backpacks.

Human Immunodeficiency Virus / Acquired Immune Deficiency Syndrome (HIV/AIDS) is a chronic, life taking and helpless condition that arouses due to compromised functioning of a person’s immune system. According to National Health Policy-2015 growth of HIV/AIDS should have been controlled by the year 2007 but we have failed drastically in achieving it. Corona Virus Disease (COVID-19) has added to the burden of it. In an attempt to prevent and control COVID-19 the whole of globe stopped functioning and even the health care services related to people living with HIV/AIDS came to a stalemate. Its an attempt through this article to summarise the risk and precaution to be taken by people living with HIV/AIDS during pandemic.

Partial Androgen Insensitivity Syndrome (PAIS), a 46XY disorder of sexual differentiation where there is partial loss of function of androgen receptors (AR). The spectrum of clinical presentation can vary in adult from phenotypic female with mild virilization to under virilized male with or without genital ambiguity. Case description: A 25 years old woman presents with primary amenorrhea, ambiguous genitalia and features of mild virilization like hirsutism and voice change. After admission in Reproductive Endocrinology and Infertility Department of Bangabandhu Sheikh Mujib Medical University, she underwent genitoplasty, vestibuloplasty and bilateral gonadectomy. Histopathology of the atrophic testes revealed Sertoli cell tumor. Conclusion: Partial Androgen Insensitivity Syndrome (PAIS) is presented clinically as ambiguous genitalia, as predominant female to male phenotype with varying degree of virilization. Multidisciplinary approach of management aims at appropriate sex assignment, reconstructive surgery, gonadectomy to prevent tumor genesis and hormone replacement therapy.

The World Health Organization (WHO) is a agency which works for international public health. It is headquartered in Geneva, Switzerland, with six semi-autonomous regional offices and 150 field offices worldwide. The WHO has prio role in several public health achievements, most notably the eradication of smallpox, the near-eradication of polio, and the development of an Ebola vaccine. The WHO generated an Incident Management Support Team on 1 January 2020, one day after Chinese health authorities identified the organization of a cluster of pneumonia cases of unknown etiology. Many countries are affected because of COVID-19 breakthrough and fighting with available resources. WHO has aligned branch OpenWHO which is interactive, web-based, knowledge-transfer platform offering online courses to improve the response to health emergencies. OpenWHO has created online courses to educate healthcares. So they more than thirty courses to learn and understand COVID 19 all aspects. These courses are online and we have to invest some time to learn via many videos and presentations. We can complete courses from minimum 1 hour to 10 hours depend on which course we choose. They provides us certificate after completion of 85% course.