The presence of a foreign body in the middle ear is a rare clinical situation. They represent 1% of otologic disorders and less than 0.4% of all consultations in emergency services [1, 2]. This accident is a real emergency which sometimes threatens the vital prognosis. It poses two problems concerning its location and its extraction. We report the clinical case of a patient followed for chronic otitis media who accidentally introduced a metallic foreign body into his right middle ear.

Mousetrap appliance is an effective treatment modality for anterior open bite that utilizes implants inserted into the anterior palate and brings about open bite correction by intruding the maxillary molars. This is a finite element study that assesses the stress contours at the bone mini-screw interface, when the maxillary molars are intruded by a mousetrap appliance. Materials and Methods: A finite element model of the maxilla and the mousetrap appliance made of 288332 elements and 64771 nodes was generated using software tools like MIMICS and HYPERMESH. A simulated force of 100 grams was applied to the maxillary molar through the appliance and the stress contours were assessed. Results: In the cortical bone Von-mises stress at the bone mini-screw interface was around 13.2MPa whereas in the cancellous bone it was around 0.198MPa. Conclusion: It is therefore concluded that the mousetrap appliance which exerts a force within the range of recommended force for molar intrusion generates stress contours at the bone mini-screw interface in cortical as well as cancellous bone. More stress is generated in the cortical bone.

Specialized stroke units are known to provide best care for stroke patients. However in their absence, patients are often shifted to regular intensive care units that are already overburdened. We carried out a retrospective study to identify ischemic stroke patients who can be safely cared outside the intensive care unit (ICU) using National Institute of Health Stroke Scale (NIHSS) score as predictor of serious morbidity and mortality. We analyzed 50 ischemic stroke patients with complete records of NIHSS score and well-documented complications, if any, while being nursed in our ICU. The results show that patients having NIHSS score between 0-4 rarely have any complications other than very trivial ones’. These patients can be cared in high dependency units or stroke wards with dedicated trained nursing staff. Furthermore we noted that the patients at maximum risk of serious morbidity and mortality have NIHSS score greater than 15. These patients frequently need ventilatory/ hemodynamic support or management of cerebral edema and elevated ICP and hence justify ICU support.

This paper examines the time-varying conditional correlations between FIRST BITCOIN CAP and ICE BofA Sterling Zero Coupon markets. We apply ten bivariate DECO-GARCH models in order to capture potential contagion effects between the markets for the period 2007-2020. Empirical results reveal contagion during the under investigation period regarding the ten bivariate models, showing potential volatility transmission channels among the markets. Findings have crucial implications for policymakers who provide regulations for the above derivative markets and for investors, who invest long-term into FIRST BITCOIN CAP.

Wall endometriosis is a rare clinical entity whose pathophysiology remains unclearI to ccurs most frequently after gynecologic or obstetric surgery. We report the case of à patient with cyclic pain at the caesarean section scar. Clinical examination showed à 4cm mass in the right iliac fossa. Tomodensitometry revealed a tissue density mass (45mm onthemajor axis). Hence, the decision to performa wide excision of the lesion. Anatomo-pathological examination confirmed the diagnosis of parietal endometriosis. Postoperative sequelae were simple with a follow-up period of 20months with no recurrence of the mass or of the pain. Our study highlights the characteristics of this disease to allow the health practitioner to understand the importance of diagnosis, of early treatment of this disease as well as of the possibility to prevent it during each gynecologic or obstetric surgery.

Increased water body contamination by heavy metals (HMs) is a serious health hazard to both aquatic biota and their predators. The degree of contamination is a function of bioavailability and bioaffinity to an organism. Metallothioneins (MTs) –a protein with high metal binding ability was used to assess the differential bioaccumulation of HMs in liver and skeletal muscles of Tilapia Zilli. HM concentration in all the liquid habitats was above the permissible limits of Federal Ministry of Environment with Zinc having the highest concentration ranging from 6.791-11.825 ppm. Exposure of T. Zilli to the three liquid habitats for 72 hours with sample collection twenty-four (24) hourly showed significant (P ≥ 0.05) induction of MTs by HMs accumulated in liver and skeletal muscle tissues of T. Zilli exposed to test habitats. Fishes showed higher induction in the downstream liquid habitat, where accumulation of HMs was higher in liver than muscle tissues. Fishes exposed to that habitat recorded MT concentrations of 102.859µg/g WWt and 83.947µg/g WWt after 72 hours of exposure for liver and skeletal muscle respectively. The liver demonstrated higher bioaccumulation potential than muscle tissues and the highest bioaccumulation factor for most of the HM was associated with the downstream habitat. T. Zilli from this study bioaccumulated HM and MTs played a vital role bioaccumulation assessment of HM. Though HM in skeletal muscles were relatively low, it still poses health threat through bioaccumulation. Thus, consumption of fish from polluted bodies needs to be avoided.

Indian planners since independence have tried to put financial inclusion at the centre of their policy. But despite nationalization of banks, establishment of cooperative societies, and many other such policies have not been able to substantially improve the livelihood of the poor. In view of pathetic financial coverage over a period of time, PMJDY was launched in 2014 as a comprehensive plan based on six pillars viz. Universal Access to Banking Facilities, Providing Basic Banking Accounts, Financial Literacy, Credit Guarantee Fund, Micro Insurance and Pension Scheme. The present study is an attempt to look into the financial literacy, financial penetration, and poverty status of PMJDY account holders in Aligarh district. The study also investigates gender wise and caste wise differential among PMJDY account holders. The study is based on primary data for which a sample of 100 households was taken on a random basis. The sample was collected from three villages of Lodha and Atrauli blocks of Aligarh district. The results show a significant gender and caste wise differential with regard to transaction by self, awareness about DBT, savings, and receiving & activating Rupay debit card. Further, there exists caste wise but not gender wise differential because of motivation/reason behind opening an account in PMJDY and agreement on fulfillment of government’s objectives. More than 80 percent of the respondents strongly agree/agree with the notion that they opened PMJDY account in anticipation that Rs.15 lakhs will be transferred into their account as promised by the present government. This simply shows the degree of political innocence of poor rural masses. Gender wise analysis clarifies that there exist a significant difference between male and female households in terms of multi dimensionally poor population but not on account of average intensity of deprivation. Dimension wise significant differential is present on education and living standard dimension but not on health dimension. Taking general category as base category, the MPI is 70 percent higher for OBCs and 230 percent larger for SCs. This shows caste wise large disparity on poverty front among PMJDY beneficiaries.

Oro-antral communication is an abnormal connection between the maxillary sinus and the oral cavity. This communication can occur due to pathological or non-pathological reasons. However, it is more common after the extraction of the maxillary posterior teeth which have their root tips close or attached to the maxillary sinus. Spontaneous healing is usually seen in OAC with less than 2mm in diameter. However, in case the OAC is more than 3mm a surgical treatment is usually considered to avoid further complications such as sinusitis. In this review, we will illustrate the appropriate diagnosis of the OAC and discuss all the surgical options for the closure of the OAC including the local flaps with the advantages and disadvantages of each technique.

The advent of Building Information Modeling (BIM) offers new opportunities to further harness the efficiency of construction projects. Hence, to implement a BIM project in construction projects successfully without unforeseen confusion and troubles, the factors affecting the project's success must be identified and managed effectively. The research objectives are to identify the CSFs for enhancing BIM implementation and investigate the interrelationships among these CSFs. Fifty-one success factors are identified through literature review and a questionnaire survey is conducted among 345 participants. The results identified 15 factors as the most critical ones among the identified 51 factors, with the “coordination between all project parties“ranked the top. These fifteen significant factors have been grouped into an integrated structural framework that can help to enhance BIM implementation in construction projects. Also, this study developed a framework to measure the performance of BIM implementation which would help to follow the progress of BIM implementation along the project life cycle.

Names are an important aspect in African culture given that the African does not name his or her children for naming sake. In most cases, names are given based on certain historical events or facts which can be peculiar to an individual, a family or the community as a whole. This is the case with the Papiackum community, a speech community situated in the Ngoketunjia Division, North West region of the Republic of Cameroon. This paper aims at analysing some of the proverbial names of this community to show that they are speech acts grounded on individual, family or collective history. From the theoretical paradigm of Social Semiotics, this study is based on the prism that Papiackum proverbial names are semiotic resources whose meanings are linked to their historical context. In this light, these names help to safeguard the history of the people for posterity while fostering social progress.

This article discusses legal pluralism and how conflicts are managed when multiple systems operate on given events. It sheds light on the case of Meng Wanzhou, Huawei's CFO, in Vancouver, Canada, who is currently facing extradition proceedings to the United States. The case sheds light on issues that can arise where legal systems overlap, in this case, those of the Royal Canadian Mounted Police (RCMP) and the Canadian Border Services Agency (CBSA), which have distinct mandates and operate under a separate legislative authority. It tackles how they are jointly involved in Ms Meng's detention, interrogation and ultimate arrest and the need for an independent oversight of the CBSA which remains the only policing service within Canada that does not have some form of independent oversight body.

Polycystic ovary syndrome, also known as Stein-Leventhal syndrome is a common health problem that affects teenage girls and young women. PCOS is associated with a wide spectrum of complications in various parts of health, including reproductive, metabolic and psychological features. This Analytical case control study was conducted to Assessment of Lipid peroxidation, antioxidant enzyme Super oxide dismutase, Glutathione and Serum Homocysteine level in Patients with Polycystic Ovary Syndrome in Khartoum State in which include 300 participant divided into 200 case and 100 control, the sample used to measure Homocysteine , Glutathione, Lipid peroxidation and superoxide dismutase level in serum of participant of high body mass index in case group and normal body mass index for the control by using spectrophotometer machine . out of 300 sample divided into 200 case and 100 control , the mean and standard deviation of the total glutathione was found mean 801.30 and the reduced glutathione 132.2 while in control 748.6,103.2 respectively, and for Super oxide dismutase mean and standard deviation was found 225.2, ± 57.8 in case while in control found 195.5, ± 25.6 respectively and Homocysteine mean and standard deviation found 14.9, ± 2.1 for case and 12.1 , ± 2.5 for control lastly also the mean and standard deviation investigated while the lipid peroxidation was found 3.4 , ± 1.1 for case and 2.4 , ± 0.7 Respectively. the total glutathione mean and standard deviation in group of <5 years disease duration PCOS found 1559.6 ,± 282.6 and for duration of >5 years of disease the total glutathione mean and standard deviation found 1196.9 , ± 253.9 regarding superoxide dismutase mean and standard deviation in group of <5 years disease duration was found 227.1 , ± 57.4 and for duration of >5 years of disease the superoxide dismutase mean and standard deviation was found 222.4 , ± 58.8.The Homocysteine mean and standard deviation in group of <5 years disease duration was found14.9 , ± 2.2 and for duration of >5 years of PCOS disease found 14.8 , ± 1.9 The age interval have low glutathione mean and standard deviation among age of 15-30 year 60(30%) found 804.5 , ± 118.8Hemoctoseine mean and standard deviation in age 15-30 year found 15.3 , ± 2.5. Polycystic ovarian syndrome could be a dilemma for many women of reproductive ages irrespective of their reproductive disorders; should incorporate assessment of lipid profiles and possibly oxidative stress markers.

The study examined the perceptions of lecturers on the effects of English for specific purposes (ESP) on learner academic proficiency in Nigerian universities, using primary data sourced from a field survey in three selected Nigerian universities. The study was based on the ESP framework and the researcher set an acceptance criterion value of 2.5 for the study. The researcher combined structured interviews and a questionnaire to obtain data from respondents who are all lecturers in Nigerian universities. The data were analyzed with the Likert scale and other statistical tools such as mean, simple percentages and significant ratios. The study calculated a weighted mean value of 3.02 and found that 92% of the respondents to the interviews identified various ESP language skills as significant factors in enhancing student academic proficiency. Based on the weighted mean value of 3.02 which is greater than the acceptance criterion value of 2.5, the study observed that to a large extent, ESP has positive effects on academic proficiency of students in Nigerian universities. Following these findings, the study concluded that ESP enhances the performance of undergraduates in their chosen courses of study. It therefore recommended, among others that ESP should become part of compulsory courses in various departments as a way of improving academic proficiency of students in their chosen courses of study.

Background: The scientific framework gives us the sociology of science and Polish theory of physical culture. We should see all processes holistically, in dimensions of time, context and becoming. Aim: The author describes and attempts to explain the situation of science in Poland in the “physical culture sciences” A.D. 2020. What are problems, trends, and possibilities? Method: The main methods are: sources analysis, and scientific literature content analysis - a broad discourse. Results and Conclusions: A more holistic, systemic approach resulting from the new paradigm will allow the logical coherence of physical culture sciences to be maintained. Overarching general theory can be the foundation for detailed theories. These sciences, as interdisciplinary, should maintain relative independence or autonomy.

Hemorrhagic complications from anticoagulants are very common. Their occurrence in a critical site such as the upper airways constitutes a vital emergency. Management must ensure antagonization of the anticoagulant effect and freedom of the upper airways. We will illustrate this through a clinical case with all the clinical signs that can alert a hematoma of the upper airways, the reversion strategies of old and new anticaogulants and respiratory management. We recommend admitting the patient to an intensive care unit, withholding anticoagulants and administering vitamin K and prothrombin complex concentrate as a means of reversing AVK. For direct oral anticoagulants, their cessation may be sufficient, otherwise non-specific reversion means are used, given the unavailability of antidotes apart from Idarucizumab for Dabigatran. For respiratory management we recommend a conservative attitude and in case of deterioration of the respiratory function a nasotracheal intubation under endoscopic guidance by an experienced doctor should be done. The resumption of anticoagulants must be decided according to the benefit risk ratio while involving the patient too and also taking into consideration the possibility of changing anticoagulants.