Structural systems consist of sub-systems and elements. Connection elements are needed for the subsystems and assembly and integration of these systems to the main system. Because the main system can fulfill its functional tasks when its assembly and integration with the subsystem is completed. Systematic static strength and dynamic behavior of structures, load bearing material and static cross-sectional properties as well as the strength and stiffness properties of the connections have a significant effect. The effect of the stiffness of the connection elements is higher in thin structural systems where the cross-sectional dimensions are much lower than the system dimensions. Assembly and integration are provided by using connection elements also in thin structural systems such as steel structure, scaffolding and rack structures. Therefore, the strength and stabilization of corner connections and fixing elements affect the entire system. However, while making systematic calculations, the structures, staying on the safe side, are modeled with rigid or rotatory hinged approach. When the connections are modeled as rotatory hinges, larger cross sections are required and support elements are added to prevent the system from becoming kinematic and collapse. With this approach, in buildings that require a lot of connection elements, the weight of the building increases too much and thus the cost increases. On the other hand, when the system is modeled with rigid approach, since the joints are unnecessarily excessively safe and the system's elasticity is very low, sudden overloads may result in collapse accidents and cause loss of life. For this reason, connection elements, especially in thin structures, must be modeled with real stiffness values and verified by tests under the prescribed loads. The purpose of this research is to examine the structural system design approach by modeling thin structure connection elements realistically and to create sensitivity in this regard. With this modeling method, it is aimed both to reduce costs and to prevent possible accidents caused by wrong modeling.

The purpose of the present study was to determine the working length using electronic apex locator in various intracanal mediums and cone beam computed tomography scan and to compare the lengths with the actual length of the tooth. Methods: In an in vitro setting, a total of 45 primary molar roots were decoronated till the cemento enamel junction for standardization, working length was measured with the Apex DSP (Septodont, France) at the ‘apex’ in presence of three different irrigating solutions namely 0.9 % saline, 0.2 % chlorhexidine and 2.5 % sodium hypochlorite. The radiological working length was then calculated with cone beam computed tomography scans. The collected data was analyzed using descriptive statistics. Independent‘t’ test was done to compare the working length between the groups. Results: Findings showed there was significant difference in working length determination using apex locator in presence of saline and chlorhexidine when compared to sodium hypochlorite. Also working length determination with cone beam computed tomography compared to actual length did not show any significant difference. Conclusion: Apex DSP can be considered to be accurate across a variety of irrigants commonly used in the pediatric endodontic practice. A CBCT scan can be used as a diagnostic tool for pulpal treatment when treating multiple carious lesions.

Background: Peripheral blood plasmacytosis can be seen in plasma cell leukemia (PCL) or plasma cell myeloma (PCM). As plasma cells show dysplasia or lymphocytoid morphology, they masquerade as monocytes or high fluorescent lymphocytes (HFL) on automated cell analyzer. The early suspicion and detection are of clinical importance for diagnostic and prognostic reasons. Methods: Automated cell analyzer was used for routine CBC examination. Peripheral blood smear examination was performed for enumeration and characterization of cells in peripheral blood followed by bone marrow examination and ancillary techniques. Conclusion: Lymphocyte-Monocyte peak with increased high HFL count on CBC should prompt a smear examination of the peripheral blood for circulating plasma cells and immunohistochemistry markers like CD38, CD138, CD56 should be used to establish the clonality in cells.

Introduction: Intravenous catheterization or Peripheral venous catheterization is one of the most being procedures by health care providers during patient hospitalization. For the purpose of sampling, fluids, diagnostic procedure medication administration, and nutritional supplement. Phlebitis is the most common peripheral catheter related complication. .It appears to local edema and inflammation, discomfort, redness of skin or subcutaneous. Phlebitis can be chemical, mechanical and biological at the site of puncture. Objectives: Determine the associating factors of phlebitis among registered nurses on the basis of experience and nursing education. Material and Methods: This study was an analytical cross-sectional study and conducted at Peoples Medical College Hospital Nawabshah. In this study, a purposive sampling method was used, and the sample size of the study was 90 Registered nurses. Results: The gender distribution among subjects was male 50 (55.6%) and females were 40 (44. 4%). Designation among study subjects was 80(88.8%) were staff nurses and only 10(11.1%) were head nurses. A slum of subjects said antibiotics 70(77.8%) develop phlebitis, significant with experience (p=.000). The continuous I.V fluid 80(88.9%) and intermittent fluid 10(11.1%) develop phlebitis and found significant with experiences. Conclusion: The study, examined; nurses have significant awareness for the prevention of phlebitis and maintenance of peripheral I.V. Further study also found the factors associated with phlebitis.

Internships assist college students in better understanding their field of study, career goals, and provide them with career-related experiences that employers seek. The article’s purpose is to educate college students on internships Dos and Don’ts that will help them to have a successful experience.

Women violence is a deeply rooted problem that exists in every country of the globe. For the most part; nevertheless, the international community has yet to create operational legal standards that will exclusively address the problems and intricacies experienced by women via domestic violence. Notwithstanding this unfortunate emptiness, the rights of battered women may be asserted under international and regional Human Rights Conventions that are legally binding upon ratifying States. This article articulates that the cankerworm of domestic violence though hypocritically and pretentiously combatted by the government of Cameroon through its various legal dispositions, has still, and continues to be considered by many as a silent or noiseless crime affecting the status of women. Women in the generic sense of the word, continue to be victims of domestic violence. This state of affairs has evidently posed negative implications on their various rights and integrity. The government of Cameroon has failed in respecting the international prescription and commitments in respecting the fundamental rights of women as their violation and abuses continue to be on the rise.

This paper specifically wants to analyze the effectiveness of Law Number 6 Year 2018 and Law Number 4 Year 1984 in Handling the Covid-19 Pandemic for Inter-island Travel Players in Ambon City, and Constraints in the Application of Law Number 6 Year 2018 and Law Number 4 Year 1984 in Handling the Covid-19 Pandemic for Inter-Island Travel in Ambon City. This research uses empirical juridical research. The approach used is a statutory approach, the data sources used are primary data and secondary data, data collection techniques that support and are related to this research are interviews, observation and decision studies which are then analyzed qualitatively. The results showed that the Health Quarantine Law, as well as the Disease Outbreak Law which could be used to criminalize anyone who obstructed the handling of the outbreak were not effective for inter-island travelers in Ambon city, because this has never been implemented, which is very ironic with the reality that the perpetrator these trips often violate the law in the form of not following Health protocols. As for the obstacles in the application of the Health Quarantine Law and the Disease Outbreak Law to be applied to inter-island travelers in Ambon city, namely the Factors of Law, Public Awareness, Lack of Quarantine facilities, and Lack of Government Control.

Background: Helicobacter pylori infection of the gastric mucosa is the most important aetiologic agent identified to cause chronic gastritis with consequences ranging from acute ulceration to the development of debilitating gastric cancer. Histopathologic characterisation of the disease progression from gastric biopsies is frequently required. Objectives: To determine the histopathologic pattern of gastric biopsies categorised chronic gastritis using updated Sydney classification and determined the role of Helicobacter pylori in chronic gastritis in our centre. Methodology: A retrospective study of all the gastric biopsies received in the department of Histopathology, Usmanu Danfodio University Teaching Hospital, and Sokoto between the years 2011-2020. Formalin fixed, paraffin embedded tissue blocks and slides stained with routine, special and immunohistochemical stains were used. Microscopic features detailing different pathologies were analysed and chronic gastritis were classified based on updated Sydney classification. Information on age, sex and duration of disease was retrieved from request cards and case folders. Collected data analyzed using SPSS version 20. Results: There were 252 gastric biopsies received, 137 male and 115 female patients and a ratio of 1.2:1. Their ages ranged from 16 to 82 years and peak in the 6th decade of life with a mean age of 46.5 years. The most common diagnosis was chronic gastritis and constitutes 85.5% (215 cases), followed by adenocarcinoma (10.3%), gastrointestinal stromal tumour (2.4%) and gastric ulcer (2.0%). Among chronic gastritis, 47.4% were H. pylori associated. Moderate to severe activity and inflammation were seen in 45.6% and 48.4% respectively. Mucosal atrophy (Atrophic Gastritis) was seen 81.4% while 19.5% show complete or incomplete intestinal metaplasia. Conclusion: Helicobacter pylori organism was the common cause of gastric morbidity in our environment, causing chronic gastritis with predominantly mild to moderate grade of inflammation, mucosal atrophy, activity and organisms colonisation.

The uneven distribution of population in Indonesia resulted in many problems that must be experienced by the government and society in fulfilling the population administration data. The method used in this research is a qualitative method. Data collection techniques are carried out using participatory observations, interviews and documentation studies. Data analysis is done with descriptive techniques through three flows of activities that are one unity, namely: data reduction, data presentation and conclusion drawing. The results showed that the innovation of Indonesia's movement-conscious administration program includes 16 innovations in communication, resources and bureaucratic structures in population data collection services with inhibitory factors consisting of uneven socialization, low public arrest in understanding the procedures of population requirements and limited aging resources and poor budget in the implementation of population data collection and supporting factors including responsive employees, good communication between employees, support of adequate facilities and infrastructure.

For the survival and growth, every organization should be capable to translate its mission, vision, goals, objectives, plans and programs enhancing performance. Rastriya Banijya Bank limited (RBBL) was incorporated in 1966 through enactment of special statute on Rastriya Banijya Bank (RBBL) Act.1966, with mains objective to provide banking and financial service related business in the country. In this context, this article explores the capacity and performance level of Rastriya Banijya Bank limited and discussion about contribution of RBBL in banking business in Nepal. Continuous performance is the objective of any organization because only through performance, organizations are able to grow and progress. For the discussion, about Performance of RBBL, operating status of RBBL, financial status of RBBL, total investment Share and loan investment, dividend received, contribution on business credit transfer, Revenue generation, Shareholder's Fund/net-worth, working capital, administrative and unfunded liabilities of RBBL on the based on PBM theory assumptions. Secondary data are obtain from Ministry of Finances and National planning commission and some of the key personnel of the RBBL are also interviewed. The finding shows that there are still very important roles of RBBL for service delivery system, social and economic development, and the roles of income Tax; value added tax and not taxable-tax collection and social welfare, Employees' generation, curtailing, syndicate and market control, the role of crisis management and emergency situation etc.

In the pathogenesis of rheumatoid arthritis and primary biliary cirrhosis, the tumor necrosis factor-alpha has an important role. We describe the case of a 61-years-old woman with rheumatoid arthritis and primary biliary cirrhosis treated with anti-tumor necrosis factor-alpha agents. During treatment with golimumab, we found an improvement in liver function, but rheumatoid arthritis remained poorly controlled. When etanercept was started, the disease activity of rheumatoid arthritis was significantly improved and liver function was also improved despite the appearance of Pityriasis Rosea during etanercept. This case shows that etanercept therapy maintained liver enzymes within normal limits in PBC and controlled arthritis with a 10-month follow-up but the maintenance of this treatment was limited by the appearance of the pityriasis rosea.

PEX is a systemic disease with ocular manifestations represented by deposition of white fibrillogranular material on the internal tissue of the eye. It is an age related and environmentally influenced disorder of the elastic fibre structure. Pseudo exfoliation is present worldwide in every race and ethnic group with variable prevalence. Methods: A retrospective descriptive study of records of 398 patients, scheduled for cataract surgery in the martyr Sohail Alatrash eye hospital- Benghazi from 1-Januray-2010 to 31-May -2010, were included. Demographic parameters like age and sex as well as clinical Features including the presence of PEX were collected. Results: Out of 398 patients enrolled, 56 were diagnosed with PEX. A statistically insignificant relationship was found between PEX and advancing age in both males and females (𝑃> 0.005). Conclusion: We found the prevalence of PEX syndrome among Libyans patients with age –related cataract scheduled for surgery aged 40 years or older to be 14.1%.

In current scenario transdermal delivery of bioactive molecules has become an interesting research area. Transdermal delivery enables direct entry of bioactive molecules into systemic circulation, bypass of hepatic metabolism, improves patient compliance, and low risk of injury to the tissues. Though it is one of the attractive routes, transport of drug through the skin has remained a challenge. To overcome the challenge, vesicular system has been adopted so as to have better skin permeation of bioactive agents. Vesicular system like liposome has shown inefficiency to cross the layers of skin. To overcome this hurdle a novel vesicular & non-invasive drug delivery system Nanoethosomes was developed. Nanoethosomes are used for deeper permeation of bioactive molecules. The main components are phospholipids, ethanol, and water. Presence of high amount of ethanol in their structure differentiates them from other vesicular systems and also helps to release encapsulated material into basal skin layer and blood circulation. Ethanol gives a net negative charge on vesicle surface promoting its size reduction. Vesicular system gives a better patient compliance, being a non-invasive method of drug administration. In this review article we are going to see brief information about methods of preparation, characterization and pharmaceutical uses of Nanoethosomes.

Wilms tumours with a greater number of heterologous elements on histology are considered as teratoid form of Wilms tumour. The presence of teratoid components in Wilms tumour are resistant to chemotherapy and may warrant additional treatment. On microscopy, the epithelial component in Wilms tumour most commonly present in form of tubules or glomeruloid bodies as homologous differentiation and less commonly as heterologous elements such as squamous or mucinous epithelium. Other common heterologous elements described in the literature are skeletal muscle, smooth muscle, adipose tissue and cartilage. Though the transitional lining is homologous to the kidney, nests of urothelial cells within Wilms tumour is not described well in the literature. We describe the presence of urothelial nests intimately admixed with other homologous and heterologous components of Wilms tumour in post-chemotherapy nephrectomy specimen.

“Spring” Op. 24 by Beethoven is one of the most famous classical sonatas for violin and piano. It can also be seen as the mirror of the composer’s creative and philosophical personality. Among the 10 violin sonatas by Beethoven, the ‘’Kreutzer’’ and the “Spring” are played the most. This sonata is in F Major tonality. Beethoven composed it between 1800 and 1801, and dedicated to count Moritz von Fries. One of the most notable features is that it contains many dialogues between the two instruments. Most of Beethoven’s works are homo-thematic. Beethoven Sonatas are an essential part of the violin repertoire in that they challenge the players’ musical and technical abilities. According to Lewis Lockwood, in his first period works as in Sonata Op. 23, piano had the biggest role. But in Op. 24 Sonata this feature had changed and the Piano and Violin have equal roles. Both instruments have melodic and thematic parts and the balance between them has an influence on the beauty of this Sonata. Before the “Spring” Sonata, Beethoven always presented the main theme in the piano. One of the most visible differences in this Sonata is that the main theme is presented by the Violin. He composed also one more movement named ‘’Scherzo and Trio’’ and made a 4 movement Sonata. This Sonata could also be seen as a role model to Op. 30 No. 1 C Minor Violin Sonata and Op. 69 A Major Violoncello Sonata. According to the Beethoven biographer Wilhelm von Lenz, Beethoven’s creative periods can be divided into three: First period shows influences by Mozart and Haydn in musical form, harmony and tonal relationships. Middle period is most commonly referred as “escape” because he was searching for a way to escape from Haydn and Mozart’s styles. Op.24 Spring Sonata is between first and middle period of his works. Because of this, Spring Sonata has effects of new techniques but still has Mozart influences. According to Lewis Lockwood, Beethoven wanted to create extraordinary elements of beauty in this Sonata, so he used special techniques of his previous works as well as other composers [ ]. This sonata and some of his other works show Beethoven’s love to his country and to the beauty of nature. Many researchers have not found information about the name of this Sonata. Lewis Lockwood said that people started to use this name in 1860s. According to him this name “Spring” is the most suitable one to show elegant melodic structure.