Introduction: A urinary tract infection (UTI) is an infection in any part of urinary system namely kidneys, ureters, bladder and urethra. UTIs are caused by both Gram-negative and Gram-positive bacteria, as well as by certain fungi. The most common causative agent for both complicated and uncomplicated UTIs is uropathogenic Escherichia coli (UPEC). Materials and Methods: This is a prospective study and observational study conducted in the Department of Microbiology, Surabhi Institute of Medical Sciences. A total of 200 consecutive urine samples were screened from patients with symptomatic UTI. Clean-catch midstream urine samples were collected in sterile disposable container and processed within one hour. Semi quantitative loop measuring 2.2 mm diameter with a holding capacity of 0.004ml was employed to culture urine on CLED agar and MacConkey’s agar. The inoculated plates were incubated over night at 370C Isolates in significant number (colony count ≥ 105 CFU/ml) were identified by standard procedures. Results: A sum of 200 patients who satisfied the inclusion principles during the investigation were enlisted. The present study shows the pathogens causing UTIs and their antibiotic susceptibility pattern. Escherichia.coli 48.5% was the predominant pathogen followed by Klebsiella pneumoniae 23%, Proteus spp. 13.5%, Staphylococcus aureus 7.5%, Pseudomonas aeruginosa 2.5%, Citrobacter spp. 3%, Staphylococcus saprophyticus 0.5%, Enterococcus faecalis 1% and Acinetobacter spp. 0.5%. In our study, high susceptibility of meropenem (76.2%) and imipenem (72.1%) was seen and least were Ciprofloxacin 13.5%. Conclusion: Infections caused by ESBL- producing bacteria often limits therapeutic options, leading to high disease burden. Therefore, diagnostic laboratories are in need of reliable, cost efficient and less labour-intensive methods to use in the detection of ESBL- producing bacteria. The public health implications of this are disturbing thus the need to rapidly detect these pathogens in the laboratory.

Background: Antimicrobial stewardship (AMS) programs have shown to reduce the emergence of antimicrobial resistance (AMR) and health-care-associated infections (HAIs), and save health-care costs associated with an inappropriate antimicrobial use. Methods: This is a prospective, descriptive and observational study conducted at Department of Microbiology, Surabhi Institute of Medical Sciences over a period of 1 year included 410 patients. Patients of either sex of any age who have been admitted inward and on antibiotic therapy were included. Outdoor patients were excluded in our study. Conducted from various clinical Departments such as Medicine wards, Surgical wards, Paediatric wards and Orthopaedics wards. All data was be documented and reviewed periodically. Any deviations from the agreed criteria were communicated, discussed, and documented. Results: On the basis of gender, frequency of Male patients were recorded little bit higher (62.6%) than female (37.4%). So, the hospital attendance rate of this study was male predominant. Majority of subjects belonged to 21-40 years (32.1%) followed by 1-20 years (29.5%) of age range. When it is categorized according to ward, in Medicine ward was recorded 34.8%, and for Orthopaedics it was 20.0%, while 30.9% for surgery and 14.1% paediatrics wards. For this study, subjects were categorised in eighteen groups on the basis of their diagnosis. Out of which, majority of the population (20.50%) were found with diagnosis of carcinoma followed by orthopaedic diseases (19.90%), while least number of patients (0.9%) were diagnosed with ophthalmological as well as thyroid diseases. Beta lactam and Cephalosporin were found the most frequent used first antibiotic even after surgery. Even for the each wards, Beta lactam and Cephalosporin were recorded highly significant and most desirable choices among all the antibiotics. Conclusions: Implementation of a multidisciplinary antibiotic stewardship program in this academic, large, Indian hospital demonstrated feasibility and economic benefits.

Introduction: Breast cancer is regarded as the most common cancer among women, and about 6.6% of cases are diagnosed among women 40 years old or younger. Inflammatory cells can regulate the tumor microenvironment and are clearly implicated in tumor development by facilitating proliferation, migration, and survival. Several cytokines, including interferon-a, interleukin (IL)-2, IL-6, IL-8, IL-10, and tumor necrosis factor-a, have essential and coordinated functions in breast carcinogenesis. Materials and Methods: This is a prospective study and observational study conducted in the Department of Pathology, Dr. V.R.K. Women’s Medical College Teaching Hospital & Research Centre over a period of 1 year with a sample of 40 patients. Two to five grams of tumour tissue and another sample from the normal peri-tumoural breast tissue were taken from the resected breast immediately after surgery. Specimen were fixed in 10 % buffered formalin, processed and embedded in paraffin. Paraffin section was stained with hematoxylin and eosin staining for histopathology and grading of the tumour. Immunohistochemistry was done for detection of cytokine IL 10 following a standardized protocol described earlier. Results: The mean patient age was 50 years (range 30-70years). Even though either side of the Breast can be affected in Ca. Breast, for the reasons not known there is slight preponderance to left side breast. Most of the gross tumours were of size 4-5 cms (n=17 i.e, 42.5%) followed by 5- 6 cm (n=10 i.e, 25%). Majority of the patients are categorized as grade-II i.e. 47.5% of cases and next is grade-I tumours i.e. 30.0% cases. All grade 3 tumours expressed strong expression of IL-10 indicating that probably IL-10 expression is more in high grade tumours. Conclusion: IL-10 may serve as a useful biomarker with potential prognostic value as there is statistically significant association of high IL-10 mRNA levels and the breast tumour tissue when compared with peri-tumoral tissue. Evidence from various studies suggests that IL-10 within tumour tissue has an important role in initiation and progression of breast carcinoma. This is also supported by high serum IL-10 levels noticed in such patients, although the mechanisms involved in the process are not exactly known.

Background: Oligohydramnios, characterized by an amniotic fluid index (AFI) of ≤5 cm, is associated with increased maternal and perinatal risks, including fetal growth restriction, abnormal labor patterns, and higher rates of operative delivery. Timely identification and intervention are essential to improving outcomes. Aim of the study: To evaluate maternal outcomes in pregnancies complicated by oligohydramnios, with a particular focus on delivery methods, antepartum complications, and the effect of L-arginine supplementation. Methods: This prospective observational study included 115 pregnant women diagnosed with oligohydramnios at Department of Obstetrics and Gynaecology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. Data on maternal demographics, obstetric history, antepartum complications, labor characteristics, and delivery outcomes were collected. Management included hydration, rest, fetal surveillance, and in selected cases, L-arginine therapy. Statistical analysis was performed using SPSS version 26. Result: Most participants were aged 20–34 years (92.17%) and had normal BMI (53.91%). Common complications included anemia (37.39%) and hypertensive disorders (31.30%). Induced labor was required in 75.65% of cases. The most frequent mode of delivery was vaginal (55.65%), followed by emergency cesarean section (33.91%). Emergency cesarean indications were mainly non-reassuring fetal heart rate patterns (79.13%). Conclusion: Oligohydramnios significantly increases the risk of emergency interventions and adverse maternal outcomes. Early detection and close monitoring, along with supportive therapies such as L-arginine, may help optimize maternal and fetal well-being.

It is no longer a debate that international remittance has a positive influence on economic growth as it goes into individuals to meet family needs, but what has not been settled empirically (at least in the case of Nigeria) is the end-use allocation of this resources. This study assesses the expenditure pattern of international remittances on productive assets purchase using a micro cross-sectional data obtained from 2009 World Bank’s Migration and Remittances Survey in Nigeria. The model estimated was based on a new approach, using the bivariate probit regression equation which saw remittances and productive assets as endogenous variables determined by some observed variables. The main result is the insignificant positive effect of migrant remittances on propensity to acquire productive assets among Nigeria’s households.

Background: There is an increasing burden of care for chronic noncommunicable diseases on the health care system, in particular, in mixed urban-rural districts where resource constraints and limited health workers threaten continuity of care. Nurse practitioners (NPs), who have received clinical training to assess, diagnose, and educate patients, are coming to play an increasingly important role in the care of people with chronic diseases. Thrown into the limelight of chronicity, NPs and their roles and practice barriers are less documented, at least in some Indian settings. Objectives: This study was to describe the extent of the NP practice in managing chronic disease and examine self-perceived competency across core clinical and educational domains, and activity options, in addition to exploring the regulatory, organizational, and interprofessional factors that make possible or hinder the NP effectiveness in Osmanabad district, Maharashtra. Methods: A descriptive cross-sectional survey was carried out among 80 conveniently selected NPs employed in primary and community health centres of Osmanabad. A self-assessment questionnaire was validated and used to assess five domains: clinical assessment, treatment and medication management, patient education and self-management support, care coordination, and system roles. The Likert-scale items were analysed using descriptive statistics (means, standard deviations, frequencies), and open-ended responses were subjected to thematic analysis between two independent researchers to identify the barriers and facilitators. Results: NPs performed history-taking (mean 4.6 ± 0.5) as well as initiating pharmacotherapy according to guidelines (4.4 ± 0.6) with high competence, indicating their good clinical basis. Adverse-event monitoring (3.9 ± 0.9) and telehealth follow-up (3.9 ± 0.9) scores were below average for continued education. A high degree of commitment to patient empowerment for self-management was indicated for patients' understanding of the disease process (4.5 ± 0.6) and for showing them how to perform self-monitoring (4.3 ± 0.7) (domains of patient education). Regulatory and restricted diagnostic authority and restricted diagnostic authority were primary barriers, and supportive interdisciplinary teams and access to decision-support tools were key facilitators, as revealed by thematic analysis. Conclusion: Nurse practitioners in Osmanabad are significant providers of care for chronic disease, but need further training in the management of adverse events and telehealth delivery. And so, policy reforms that are providing NPs with diagnostic and prescriptive autonomy, that are being combined with structured capacity-building interventions, will maximize the impact and influence of their contributions.

Epithelioid malignant peripheral nerve sheath tumor (EMPNST) known as "epithelioid malignant schwannoma", described for the first time in 1954. It is an entity that has the same clinical features as MPNST but whose cytological and histological characters are different. It is characterized by an epithelioid cytomorphology, usually diffuse S100 immunoreactivity and some cases come from preexisting schwannomas. Clinically, it presents as a painful or asymptomatic mass, whether or not it is located on a nerve path. Imaging plays an essential role in preoperative diagnosis and assessment, but histology remains the key examination for confirmation of the diagnosis. Treatment is based on surgery, radiation therapy and chemotherapy. His prognosis is grim. The objective of this work is to underline the histopathological aspects of this very rare entity, in particular in children, by reporting an observation of a 21 month old infant.

Face recognition presents a challenging problem in the field of image analysis and computer vision as such a large number of face recognition algorithms have been developed in last decade. In this paper firstly I present an overview of face recognition and discuss its application and technical challenges. Thereafter I represent the various face recognition techniques. This includes PCA, LDA, ICA, Gabor wavelet, soft computing tool like ANN for recognition and various hybrid combinations of these techniques. This review investigates face recognition and all these methods of face recognition with parameters that have challenges like illumination, pose variation and facial expressions.

Background: Prosthodontics is the branch of dentistry that deals with the replacement of missing teeth and other orofacial structures with artificial substitute. In prosthodontics, implants, removable and fixed dentures can be used to replace missing teeth. Digital dentistry is the new trend that is evolving globally among the dental professionals and the dental students. Interactive learning concepts and objective evaluation in this digital Technologies with 24/7 access to the dental undergraduates and post graduates in providing education and training about prosthodontics is highly valuable. Aim: The aim of this study is to do the systematic review of the online Data available for educational applications for Prosthodontics. Materials and Methods: In order to conduct a systematic review of the online data available for educational applications in prosthodontics, the rules and guidelines of preferred reporting items of systematic reviews and meta-analysis (PRISMA) were followed. Results: Of the total 453 articles only about 11 articles ware included in the systematic review that reported the online data available for educational applications in prosthodontics. Conclusion: The dental education of prosthodontics can be revolutionized, using the online available data to create educational applications.

Sars-Cov-2 could occur in active tuberculosis patients; with risk of aggravation, could also reveal tuberculosis or infect former tuberculosis patients.

Speeding is one of the main causes of traffic crash fatalities. Different effective strategies have been applied to prevent this critical issue; for example, humps, setting speed limit, and speed cameras. This study evaluates the effectiveness of speed cameras that are implemented on midblock of urban, suburban and on segments of rural arterials in Jordan in January 2018. Interrupted time series analysis (ARIMA model) was used for examining the effects of the speed cameras on the number of crashes. Various functions; including linear, quadratic, logarithmic, exponential, and power, were applied in order to evaluate the effect of speed cameras on traffic crashes. Results of analyses indicated that speed cameras implemented on suburban and urban arterials with speed limit less than 80 km/h had a crash reduction of 10 to 19%. On the contrary, it was found that the number of crashes on a limited number of rural arterials’ segments was increased by about 36%, this result should be further investigated since the sample size of rural segments was relatively small.

The economic implications of using solely wind energy or solar photovoltaic (PV) system for electric power generation in Nigeria is considered in this work. Twelve states from the six geopolitical zones of Nigeria were used as case studies for wind energy utilization while 6 states were used for solar energy usage. Wind speed and solar radiation data for the state capitals were used for the analysis. The net present value (NPV) and the levelized cost of electricity (LCOE) for each state for a project lifespan of 20 years was estimated for each power system in the various states using discount rate equivalent to the prevailing interest rate (16%) in Nigeria and lower values. At 16% discount rate for wind energy system, only 4 states gave positive NPV while at 8% discount rate 9 states have positive NPVs. For the solar PV system, the NPVs are negative for all the 6 states at 16% discount rate while only one location with the highest average annual solar radiation of 6.4 kWh/m2 day gave positive NPV at 8% discount rate. The LCOE is smaller for wind energy systems in many of the locations considered. When energy is not discounted, the highest and the lowest LCOE for wind energy system are 0.1937 $/kWh and 0.0167 $/kWh respectively while the respective values for solar PV system are 0.0615 $/kWh and 0.0415 $/kWh. The LCOE when energy is discounted is higher and the average value obtained either system is higher than the price of electricity in Nigeria but lower than the electricity price in the UK and the USA. Thus for wind and solar PV systems to be more economically viable for electricity generation in many locations in Nigeria, the current installation costs should come down and or the price of electricity should go up.

Many jurisdictions encourage the adoption of electronic commerce by enacting statutes that enable contractual dealings to be conducted electronically, and also allows people to use an electronic signature to satisfy any legal requirement. Even the electronic transfer of land is covered under certain statutes as in the case of the Indian Information Technology Act, 2000. However, in the era of globalization; and in the absence of any geographical boundaries for the cyberspace, such new legislations also raise some questions: for how long will these statutes be valid? What are the boundaries of these statutes? Who should be forced to follow them? Most of these questions are unanswerable today. The exponential growth of the internet and online activity raise a number of legal questions. How does copyright apply to digital content? How can national laws apply to cyber wrongs in cyberspace? Can privacy and data protection exist on the cyber space? Can electronic commerce really be secure? Can cyberspace be regulated by one, or by many authorities? In seeking to apply the law to the Internet, problems arise owing to the fact that most laws largely apply to the pre-cyber space world. As the technology improves and ownership of home computers increases, one competently navigate his way around cyberspace, downloading information, reading and writing to newsgroups, and receiving and sending emails. Cyberspace represents the new medium of communication, electronic communication, which is fast outmoding, or even replacing, more traditional methods of communication. The present Study attempts a comprehensive definition of the term ‘cyberspace,’ traces out the evolution and growth of cyber space; and enumerates the pros and cons of information technology. In traditional and online trading environments, consumers are entitled to have their privacy respected. While shopping on the internet; most people typically do not think about what is happening in the background. In the modern era of electronic technology, people want to get their work done quickly with little effort. At times, people forget or ignore the legal and ethical values of their actions. Consequently, cyber wrongs in different forms are increasing day by day: cracking/hacking, e-mail spoofing, spamming/Denial of Services (DOS attacks), carding (making false ATM Debit and Credit cards), cheating and fraud, assault by threat, impersonation, intellectual property rights (IPR) infringements (software piracy, infringement of copyright, trademark, patents, domain names, designs and service mark violation, theft of computer source code, etc.), online gambling and other financial crimes including the use of networking sites and phone networking to attack the victim by sending bogus mails or messages through internet, forgery, URL hijacking or squatting (using the domain name of another person in bad faith), cyber vandalism (destroying or damaging the data when a network service is stopped or disrupted), virus transmission, internet time thefts, pornography, cyber terrorism etc-the list is endless. Customer information has to pass through several hands; and the safety and security of a customer's personal information lies within the hands of the business. Therefore, security and privacy of the information are a major concern. E-commerce has a tremendous impact on copyright and other intellectual property rights (IPRs).

American voters elect the President and Vice President of the United States of America indirectly, through an arrangement known as the Electoral College system. The U.S. Constitution, in Article II, Section 1, Clause 2, as amended by the 12th Amendment in 1803, together with a series of implementing federal statutes, provides the broad framework through which electors are appointed and by which they cast votes for the President and Vice President. However, the Constitution says nothing about how the states should allot their electoral votes. The winner- take-all was the choice of the majority of the States. Presently, 48 states and the District of Columbia (Maine and Nebraska are the exceptions, having adopted the district system) have adopted the winner-take-all method of allocating electors. Under this method, the slate of electors, representing the presidential and vice presidential ticket that wins a plurality of votes in a state is elected on Election Day in November, and later meets in mid-December as the Electoral College to cast all of the state’s electoral ballots for the winning presidential and vice presidential candidates. This electoral system has proved undemocratic in modern time. The objective of this paper is to shed light on the limits of the American presidential electoral system which is no more in accordance with the ideals of the democracy today. Through historicism and Marxism theories, investigations have shown that some candidates can get a majority of the popular votes but fail under the winner- take-all conundrum. More importantly, the system has generated a dangerous geographical separation with red and blue territories in the same United States. The compromises and ideals of 1787 constitutional convention are rather outmoded for the 21st century democracy.

This study was conducted to assess the influence of epidemiological risk factors in the formation of renal calculi, their compositionand association with urinary tract infections (UTI) among the ethnic population of Khammam district, Telangana state. This study included 56 subjects attending the urology department, Mamata General Hospital, Khammam. Out of 56 patients with renal calculi, 50 are male, 46 from rural areas, 22 were farmers and 26 were manual labor. Twenty six belonged to socioeconomically lower middle class, 38 were non-vegetarians and 47 were consuming bore/tank water. Results of this study suggest a significant association between all the epidemiological risk factors viz., gender, residence, occupation, socio economic status, diet, and source of water and formation of renal calculi. Structural analysis of stones demonstrated that 78.6% of stones were mixed. Overall, calcium oxalate as pureor mixed with otherchemicals was the main component of stones matrix, seen in 38 (67.9%) patients. In this study, struvite is present in 21.4% of the stones. Thirty (53.6%) of 56 urine specimens were culture positive and 26 (46.4%) were sterile. All the positive urine cultures yielded a single organism and 26of 30 isolates were positive for urease enzyme. Klebsiella was the most common organism and was isolated from 16 (28.6%) urine samples. Results suggest that there is a significant association between UTI and renal calculi formation.