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.

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.

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.

Main Street written by Sinclair Lewis is rich in meaning and with high value. The existing research ranges from realism, modernism, and narrative techniques. However, the research on Main Street from the perspective of new criticism is limited to irony, which is only a part of the new criticism and is not sufficient and in-depth. Moreover, generally speaking, researching results are few. This paper tries to apply a new critical analysis of Main Street, including four dimensions-tradition and individual, structure and muscle, polysemy and non-generative - to explain innovational spirit. First, Main Street under the rebellious spirit has modernism and originality, which ensures the author's distinctive characteristics. Second, this paper explores the tension beauty of characters under the theme of rebellious spirit through quantitative analysis, due to its vividness, simplicity, universality and rationality. The plot tensions verify in case of structure and muscle, but literature features in both literariness and accuracy. Third, the ambiguity reflects the way in which tension presents, which is an indispensable part of literature. Fourth, innovational spirit gradually verifies from invisibility to visibility through character and rural culture, whose process is non-generative.

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.

Garbage is a problem faced by almost all countries in the world. Increasing the volume of waste requires good and effective management. In Makassar City, waste management is regulated by the Regional Regulation Number 4 Year 2011 concerning Waste Management, which can be said to be a responsive regional regulation because it has accommodated the involvement of various parties, especially the community and the business world in waste management in Makassar City. The local government of Makassar City determines two types of solid waste or cleaning service policies, namely the Communal Service Policy (Indirect Service Policy) and Individual Service Policy (Direct Service Policy). Effective waste management in Makassar City is measured by the form of services provided by the government and the fulfillment of solid waste facilities and infrastructure in Makassar City. In terms of services, these services are provided every day by the local government of Makassar City through their apparatus. Then regarding the facilities and infrastructure, the Makassar City Government has made efforts to fulfill all facilities and infrastructure, especially related to waste transportation.

Common fetal urinary tract abnormalities encompass a complex spectrum of abnormalities grouped under the name CAKUT, which can be detected antenatal by ultrasound with an incidence of 1 to 4 in 1,000 pregnancies. As such, they represent 15 to 20% of all birth defects. They remain responsible for 30 to 50% of cases of end-stage renal failure, so it is crucial to have an early diagnosis and medical or surgical management in order to minimize renal damage and to avoid or delay a possible renal failure. Through a study carried out within our structure comprising 36 cases, we will recall the most frequent fetal anomalies of the kidneys and urinary tract by specifying the ultrasound modalities and the prognosis of these various malformations as well as the recommendations for pre and postnatal management.

Acalvaria Is a rare congenital disease considered as a post-neurulation defect: It consists of the absence of Calvary bones, dura mater and associated muscles in the presence of a normal skull base and facial bones normal. Currently, there is no identified cause of Acalvaria. The main putative pathogenesis is the problematic migration of the membranous neurocranium from the normal positioning of the immature ectoderm. Although the malformation has been fatal to date with only a few survivors, the prenatal diagnosis of Acalvaria is of rather remarkable importance as it allows clinicians to plan appropriate and timely management. So that this fetus can benefit from surgical advances.

This paper will analyze the licensing problem which is a constraining factor for investment in Indonesia. This type of research is a normative legal research, using a conceptual approach and statute approach. The data used are secondary data consisting of primary legal materials and secondary legal materials. The collected data were then analyzed qualitatively. The results showed that the reality today is that many investors have very low confidence in the investment climate in Indonesia, this is because there are still a number of obstacles that RI needs to tackle. Licensing improvements with the Online Single Submission system and the provision of various tax incentives such as tax holidays and tax allowances are not sufficient. The government, needs to re-simplify procedures when investing, such as land acquisition and other licensing issues. Apart from these two obstacles, there are also other hindering factors. For example, inconsistent government policies, no central and regional coordination, as well as wages and labor issues. A good investment climate will certainly have a big impact on the investors who come. The investment climate which is considered conducive will indirectly also affect the services for these investors. The Job Creation Law is an effort that is considered to be able to improve the investment climate in Indonesia after the pandemic that occurred.

Rehabilitation arrangements for narcotics abuse users in Indonesia have been regulated in Law Number 35 Year 2009 concerning Narcotics. The relevant law describes the function of rehabilitation, but does not specify the categories that are eligible to receive rehabilitation facilities. The elaboration regarding the requirements for receiving the rehabilitation facility is only spelled out in the Supreme Court Circular Letter Number 04 Year 2010. This in turn can lead to wrong actions against narcotics abusers. The implementation of medical and social rehabilitation for narcotics abusers in Indonesia has begun to be improved. This can be seen from the improvement in the quality standards of the rehabilitation facilities, as well as the efforts to strengthen rehabilitation institutions. Referring to the ideal concept of implementing rehabilitation for narcotics abuse users in the perspective of restorative justice, rehabilitation of narcotics abusers must be provided. In this case there are two rehabilitation processes that must be provided, namely medical rehabilitation and social rehabilitation. Medical rehabilitation to restore abusers from dependence, while social rehabilitation so that narcotics abusers can be accepted back into society.

Plants have defensive proteins to survive in drought and heat conditions by activation extensive stomata systems. Different factors affected the plant growth such as drought as one of major cause in seed growth inhibition. Biotic as well as abiotic stresses cause changes in morphology and also involve at the molecular alteration or activations of certain genes. Adverse effects of high temperature on cereal crops vary with the timing, duration, and sternness of the heat stresses. Harmful mutations that have drastic effects tend to be fixed in modern breeding pools. Drought also affects the growth of certain growth promoting factors also on turgor. It leads to problems in transport of water to different parts of plants such as xylem and other cells that playing significant role in prompting the plant growth. Different techniques and software’s are currently available to under table the nature, type and function performed by each gene in biotic and abiotic stresses. Microarray as one of the best technique used for the gene expression in the plants thus helping the rescuing of disease rate in plants. Different genetic traits have been placed in special groups in order to communicate the stress groups of plants in relation to environment. Different genes are activated under stress conditions that can be potentially recognized and sequenced at the genomics level due to different methods of sequencing used for checking their specific sequence of genes.

Objective: To explore a selection of psycho-social variables with potential influence on exercise and dietary behaviors in patients with cardiovascular disease and diabetes in Saudi Arabia and to elicit salient directions and themes for further examination on a larger scale. Method: This was a phenomenological qualitative study informed by the Self-Determination Theory and the COM-B Model. It involved fully structured, open-ended interviews administered to 8 inpatients at a governmental hospital in Riyadh between October and December 2020. Data was examined using a hybrid of deductive and inductive content analysis. Results: Patients with a higher degree of basic psychological need satisfaction lived healthier lives and displayed more positive emotional responses. We detected differences between physical activity and nutritional behavior in terms of the associated perception of autonomy and competence, as well as motivational quality. The family emerged as major social support source for both behaviors. Environmental opportunities provided for exercise and diet support were commonly perceived as insufficient. Conclusions: We suspect the level of perceived psychological need support to be linked to the patients’ behavioral and psychological outcomes. We also expect local inequalities in the available behavior change support across different health behaviors and the need to adequately foster patient autonomy in clinical interventions in Saudi Arabia.

Mental imagery (MI) training is a useful experience to improve basketball free-throw (FT) shooting accuracy. The purpose of this study was to examine the immediate effect of mental imagery training on the improvement of free-throw shooting accuracy in basketball. Twenty (20) male basketball players were randomly selected as subjects. All subjects were randomly assigned into two groups: the experimental group (n=10) and the control group (n=10). A pre-test and post-test were given to every subject and each subject performed ten (10) free throws. For statistical analyses, the average values of these ten (10) free throws were used. There was a single conduct session (MI) with the experimental group lasting about ten minutes. Descriptive statistics, inferential statistics- dependent t-test, and one-way analysis of variance (ANOVA) were applied in the study, and the level of significance was p<0.05 and p<0.01. Paired sample t-test of the experimental group ware statistically significant (p<0.01) and the control group was also statistically significant (p<0.05) difference between pre-test and post-test values. However, the mean values of the post-test showed that the experimental group (mean number of successful free throws = 7.30) had a higher average number of free-throw shooting accuracy than the control group (mean number of successful free throws = 6.50). In conclusion, this study indicates that basketball players may benefit from mental imagery training to improve their free throw shooting accuracy.

Renal agenesis is the absence of any trace of kidney, ureter, and therefore the absence of fetal renal function. It constitutes a major field of antenatal screening which presents until now certain limits during ultrasound diagnosis which remains the only accessible, inexpensive and reproducible means of exploration for making the diagnosis with a sensitivity of 85%. The neonatal prognosis is considered better in the unilateral Renal agenesis with functional contralateral kidney, but is always fatal in its bilateral form. The objective of our study is to clarify the ultrasound strategy that must be adopted in antenatal to make the diagnosis while highlighting the technical difficulties that can misdiagnose. An update on the epidemiological and etiopathogenetic nature of the anomaly will also be discussed.