Background: Multiple myeloma is the majorly occurring plasma cell dyscrasia. It involves the plasma cells, bone marrow and kidneys. There is monoclonal proliferation of plasma cells which secrete light chain immunoglobulins IgG type. These immunoglobulins tend to precipitate in the form of para proteins. It has a very complex pathogenesis which makes difficult to predict the prognosis of the disease. Therefore, majority of cases go into phase of relapse or progression and may sometimes present with bone lesions which were not present in the primary disease. Case Report: A 52 year male patient presented to the out patient department of our institute. He was a known case of multiple myeloma and was in the remission phase. He complained of pain in 46 and 47 region which he had undergone extraction 3 months back. On evaluation, the lesions were found to be bone lesions present in multiple myeloma. Therefore, a diagnosis of relapse case of multiple myeloma was given. Conclusion: Multiple myeloma is a disease of variable prognosis and needs to have thorough follow up protocols and an interdepartmental approach, in order to have an early diagnosis and treatment.

Introduction: The rational use of antibiotics is a major concern due to the development of bacterial resistance and the emergence of multiresistant bacteria. The objective of this study is to evaluate the consumption of antibiotics within the HMMI for 3 years (2016 to 2018). Materials and Methods: This is a retrospective study of the consumption of antibiotics for 3 years (2016 to 2018), allowing the distribution of hospital services in 5 activity sectors; whereas the calculation of antibiotic consumption in DDJ / 1000JH made it possible to determine the overall consumption of all antibiotics of the HMMI in DDJ / 1000JH for the years 2016-2017-2018; to determine the consumption by antibiotic families of HMMI in DDJ / 1000 JH for the years 2016-2017-2018; to determine the average consumption by antibiotic families and by activity sectors in DDJ / 1000JH. Results: The analysis of the overall consumption of all antibiotic families combined showed a consumption of 861.38 DDJ / 1000JH in 2017 and 700.97 DDJ / 1000JH in 2018. While the calculation of the percentage change between the years 2016 and 2018 revealed a decrease in the overall consumption of antibiotics by (-9.07%). Analysis of consumption by families of antibiotics has shown that betalactamines are the most prescribed molecules with 77.39% or on average (601.86 DDJ / 1000JH); monitoring of fluoroquinolones with 7.21% or on average (56.08 DDJ / 1000JH); monitoring of aminoglycosides with 6.44% or on average (50.12 DDJ / 1000JH). Analysis of the overall antibiotic consumption by sector of activity has shown that the resuscitation sector is the sector most prescribing antibiotics of all families, with an average of 1345.61 DDJ / 1000 JH. Discussion: The results of our work showed high consumption, explained either by an adapted prescription policy or overconsumption by inappropriate prescriptions. Various surveys show that 20 to 50% of prescriptions for antibiotics are inappropriate in hospitals. Conclusion: The link between the use of antibiotics and the emergence of bacterial resistance is clear The present retrospective study was an important assessment. Which must be supplemented by prospective studies evaluating the quality of prescription at the level of the services most consuming antibiotics.

Uterine rupture on healthy uterus is a very rare obstetric complication; few cases have been described in the literature. We report a case of rupture taken care of in our training. Multiparity and cross-presentation were the main risk factors. The treatment was conservative with a tubal section tightening to avoid the risk of recurrence.

This study aims to analyze the effectiveness of temephos against Aedes aegypti larvae in the Buffer Airport and Poso Sea Port area. This type of research is quasi-experimental. The research sample used the first-generation instar Fed 1 Aedes aegypti larvae obtained from mosquito breeding. A total sample of 240 tails consisted of treatment and control with 3 replications each. Testing uses 1% temephos concentration. The statistical test used in univariate and probit analysis. Based on the results of the study showed that the Poso Airport Buffer, Aedes aegypti test larvae were susceptible to temephos 1% with a total mortality of 100% of the test larvae. where the WHO standard criteria state for larvae of the test 98-100% Vulnerable, 80-98% Tolerant deaths, and <80% resistant. Likewise, with the Poso Port Buffer region, the Aedes aegypti test larvae are susceptible to temephos 1% with a total of 100% average adult mosquito mortality. the overall lethal time values (LT50, LT90, LT95, LT99) in the Poso Sea Port Buffer region are higher than in the Poso Airport Buffer area, where the Poso Sea Harbor Buffer area for 1% temephos requires a longer time to kill the Aedes aegypti test larvae, compared to the Poso Sea Port Buffer region. by poso airport. Especially to kill 99% of test larvae in the Poso Sea Port Buffer region, temephos 1% takes 147.2 minutes or 2 hours 27 minutes while for the Poso Airport Buffer region it only takes 119.86 minutes or 1 hour 59 minutes to kill 99% of larvae test.

Among oral diseases dental caries is a highly prevalent multifactorial disease and has been a major public health problem for many centuries. Several remineralizing agents helps in remineralization to prevent disease progression, and to improve form and function of the teeth. Remineralization is the process of depositing calcium and phosphate ions into crystal voids in demineralized enamel, thus producing net mineral gain. The present article reviews about the various agents that enhance and promote remineralization of tooth structure and their implementation into clinical practice.

Research in Kiambu County shows a variety of farmers’ information needs. Among subsistence farmers who produce a mix of food and cash crops, land size is 2-2.9 acres. Large-scale farmers grow more cash crops. Most farmers keep dairy cattle for milk and manure. This paper focuses information needs on credit, the key emerging issues. Using a descriptive research design we gathered qualitative and quantitative data on how farmers accessed credit information they needed; sources; and usage. We took a random sample of 150 farmers, 18 to 55 years, selected from 897 farmers, covering 28 cooperatives. A descriptive research design was applied. Stratified Random Sampling technique was used, with face-to-face interviews and semi-structured questionnaires. Face-to-face interviews and semi-structured questionnaires were used. Specifically, we itemized a) farmers’ information needs and search on the sub-clusters–loans availability from providers, interest rates charged, availability of low interest rates, supplementary services offered by credit providers, and availability of government funds; b) information sources from the cluster: Cooperatives, Banks, Government Offices, Churches, NGOs, No information access, Salesmen, and Other people; and c) usage of the information and challenges thereof. The study reveals access to information on loan availability by providers, interest rates charged, and lowest interest rates were the most sought-after sets (in that order). Government funds information is the least sought. Top providers are Cooperatives, Banks and Government, in that order. On usage, loans from the cooperatives and banks finance projects such as construction of boreholes, increasing dairy animals or planting additional crops. Credit from cooperatives is flexible. It may feature loans in kind, e.g., animal feeds.

This research entitled The Effect of Dividend Payout Ratio and Earning Volatility on Stock Prices, the aim is to find out the effect of dividend payout ratio and earnings volatility on stock prices on manufacturing companies in the Indonesia Stock Exchange in 2014-2017 both in parsila maupu together. The sampling technique used purposive sampling and data analysis used panel data regression. The results of data processing show that the Dividend Payout Ratio has no significant effect on the Stock Price. Then Earning Volatility has a significant effect on Stock Prices and jointly with Payout Ratio and Earning Volatility has a significant effect on Stock Prices.

The prevalence of PTM shows an increasing trend and is the number one cause of death in Indonesia. Through Posbindu a screening of residents aged ≥ 15 years is carried out as a step to prevent and control PTM risk factors. The purpose of this research is to evaluate the Integrated Disease Development Post Program (Posbindu PTM) in the work area of Buludoang Public Health Center in Jeneponto Regency, the focus of this research is to use system theory by looking at the components of input, process, output, and feedback. This research is qualitative research with a descriptive-analytic approach, through in-depth interviews, observation and document review. The research subjects consisted of 12 informants, selected by purposive sampling technique. Data were analyzed including stages, reduction, presentation, and drawing conclusions, testing the validity of using triangulation of data sources. The results of the study, the number of cadres in each Posbindu between 2-5 people and has not been supported by SK (Certificate) so that it is inadequate, found the limitations of Posbindu (Integrated Development Post) KIT and inspection sticks, there are no KIE (Communication, Information, and Health Education) modules and media and does not involve the village government in Posbindu funding. Planning is done every year but is not problem-oriented, Posbindu is not yet supported by an organizational structure, the implementation of activities is still carried out by the PTM Puskesmas program holder and there are stages that are not carried out optimally, especially tables 2 and 5. Monitoring through monitoring is not routine and only focuses on Public health center. Service coverage is 6.9% and far from the SPM (Minimum Service Standards) target, and no coaching steps have been made to improve. Improvements are needed in the system dimension by involving the village government to maximize the implementation of Posbindu.

The increasing demand of construction is a challenge to be fulfilled in this regard different new construction materials are found to be utilized differently. One of the wall construction materials Autoclaved Aerated Concrete Block (AAC) is found to be used in Bharatpur Metropolitanof Nepal.The purpose of this research is to assess the technical suitability of Autoclaved Aerated Concrete Block as Alternative Building Construction Material for the construction of residential buildings and hotels. Laboratory test of the AAC blocks ware done .Quality control chart and t-test ware done for analysis. To test the physical properties, 5 samples of AAC block were observed for compressive strength, density andwater absorption. The compressive strength of the AAC block was found to be 4.324 N/mm2 even with a low density of 617.6 kg/m3when compared to a 3.402 N/mm2 average compressive strength of brick of 1685.8 kg/m3 density. However, the water absorption of the AAC block wasfound higher than that of the Clay brick.

Jane Eyre and Vanity Fair are two classic books in which the female images of Jane and Rebecca have attracted many readers. There are some similarities and differences in the female images as written in these stories. This paper will analyze the two female images in the two books. The goal of this article is to analyze the impact that environment and society have exercised on characters, and further advocate correct values toward friendship, marriage and family.

Asparagus racemosus Willd belongs to the plant family Asparagaceae and one of the well-known medicinal plants used in indigenous systems of medicine of Sri Lanka. It has abundant medicinal effects such as aphrodisiac, antioxidant, immunostimulant, antihepatotoxic, antibacterial, antidiabetic, anticarcinogenic, antidiarrheal, antiulcerogenic, antioxytocic, etc. Local suppliers for A. racemosus cannot meet the country requirement and therefore, mainly depends on imported A. racemosus grown in India. Therefore, an attempt was taken to evaluate the physico-chemical, phytochemical and nutritional profile of A. racemosus grown in India. Results revealed that 6.2 0.1% of total ash, 1.9 0.0% of water-soluble ash and 1.7 0.0% of acid insoluble ash were contained in roots of A. racemosus grown in India. Total phenolic content, total flavonoid content and total saponin content were 14.0 ± 0.1 mg gallic acid equivalents/g of extract 7.1 ± 0.2 mg quercetin equivalents/g of extract and 4.5±0.2 % respectively for A. racemosus grown in India. Twelve prominent spots bearing Rf values of 0.07, 0.09, 0.12, 0.20, 0.25, 0.28, 0.36, 0.48, 0.54, 0.71, 0.89 and 0.93 were present in Indian origin A. racemosus. Heavy metals such as Hg, As, Cd and Pb and microorganisms including Staphylococcus aureus, Escherichia coli, Coliforms, Salmonella and yeast and moulds were not detected in A. racemosus roots. Energy value of A. racemosus grown in India was 22 kcal/100g. In conclusion, present study illustrates a clear idea of physico-chemical, phytochemical and nutritional properties of A. racemosus grown in India.

The Sultanate of Oman which was once considered to be a very conservative country is now going through a phase of social change wherein her women have more social awareness and are becoming extremely conscious about how they look and present themselves in public. These being the case we can with surety say that this had led to them giving more emphasis to self-hygiene and looks, which has directly led to the increase in the use of cosmetic products. A plethora of cosmetic products both nationally and internationally made now flood the Omani market. This paper aims to study the behavioral patterns towards specific cosmetic products in Oman. However, beauty is not confined to one aspect alone. Hence this paper concentrates on how the Omani women respond to specific brands covering certain specific areas of care such as Personal care products (Beauty), Skin care products (Moisturizers, Hand wash & Perfumes), Hair care products (Shampoos & Oil). Within these areas also as the brands are too many, only certain prominent brands have been selected such as the below given to serve the research: (i) Beauty – Revlon, Lakme, Elle 18, Forever, Huda Beauty, Gosh, Crème Blind & Inglot. (ii) Moisturizers – Nivea, Vaseline, Ponds, Jhonson & Jhonsons, Lakme, Bath & Body, Garnier & Dove (iii) Shampoos – Pantene, Garnier, Dove, Head & Shoulders, Tressame, Sunsilk & Ultra- Doux. (iv) Oil – Parachute, Nyle, Dabur Amla, Indulekha Bringa, Dabur Almond Oil & Garnier. (v) Handwash – Dettol, Lifebuoy, Pears, Palmolive, Lux, Dove & Camay. (vi) Perfume – Oudine Melanie, Victoria secret bombshell, Gucci, Bulgari, Chanel, L’Coste & Paco Robanne.

Background: Aging is a normal process in the life of all living beings. It is a multidimensional process of physical, psychological, and social change. Some dimensions of ageing grow and expand over time, while others decline. The study looks at effect of MSRT a yoga technique in elderly to improve cognitive functions like attention, concentration, short term memory and executive functions. Materials and Methods: Elderly subjects were recruited based on inclusion and exclusion criteria (n = 30) for a single group interventional pre-post study design: MSRT (a relaxation technique) was given for a period of 1 month (30 days). The subjects were assessed on day 1 pre and post intervention on day 30 on Six Letter Cancellation Test (SLCT), and Trail Making Test-B (TMT-B). Results: After one month of MSRT practice showed significantly better performance in the SLCT test compared to baseline by Paired sample t test (P < 0.0001) and TMT-B scores (P < 0.0001). Conclusions: The results of this study establish that MSRT can be used as a technique to enhance cognition and prevent cognitive decline in the elderly.

Background: The COVID-19 pandemic is a major health crisis affecting India like other countries, with over 42,533 confirmed cases and 1373 deaths till 04 may 2020. This spread outbreaks are associated with adverse mental health consequences caused confusion, changed Quality of Life, including movement restrictions, fear of disease become panic, and closure of schools, shops and businesses, and brought about overwhelming psychological impacts, like anxiety, depression, stress, the psychological impact of COVID-19 and its relation with mental health were examined. Because of stigmatization and the fear of being labelled as someone who carries an infectious disease many at risk populations may not seek care until symptoms are unmanageable or may not seek care at all. Resilience is the capacity to cope up with stress and adversity. It is universally regarded as a positive and valued trait. Purpose of resilience is development of initiative, self-regulation and attachment, which are protective factors that can offset or moderate the effects of stress and adversity and allow to everyone to thrive of transformed by adversity. Specially, in situations of corona virus is important to nurturing resilience in individual, family and community. Methodology: In this short review, accordingly, the electronic databases, including PubMed, Medline, Elsevier, and Science Direct, Embase, PsycINFO, Google scholar, Scopus were reviewed for relevant studies (with key words )that have conducted since 2014. Results: The current review paper was carried out to indicate that COVID-19 has negative psychological problems with situational difficulties like patient isolation; contact tracing, quarantine, lockdown and infection control methods should also address the risk of stigmatization among populations and the negative effects which could occur. A review of the studies performed in other parts of the world showed that COVID-19 has caused several psychological impacts, including increased anxiety. Conclusions: By an increase in the prevalence rate of COVID-19 and its resulted movement restrictions, the level of anxiety increases, as well; therefore, there is the need to public awareness of the disease programmes and providing positive psychological intervention programs for controlling stress and reduce anxiety in general population as well as addressing stigma and discrimination targeted toward individuals affected by COVID-19 and groups at higher risks is a priority for public health and health care providers. Individual resilience is a person's ability to positively cope after failures, setbacks, and losses. Developing resilience is a personal journey. Individuals do not react the same way to traumatic or stressful life events. An approach to building resilience that works for one person might not work for another.

Background: Both theoretical and empirical evidences on chronic illness suggest negative consequences of caregiving on the psychological wellbeing and Quality of Life (QOL) of the caregivers. However, the fact remain that there is a paucity of empirical researches on the quality of life of caregivers of people with chronic mental illness. Purpose: The purpose of the present research is to assess the Emotional Quality of Life among caregivers of person with chronic mental illness across gender. Setting: Psychiatric Hospitals and clinics Lucknow, Uttar Pradesh, India. Participants: The sample comprised of 100 primary caregivers of person (50 were male caregivers and 50 were Female caregivers) with diagnosed chronic mental illness of Schizophrenia, Anxiety Disorder, Personality disorder, Depression and Bipolar affective disorder (BPAD). Those willing to participate in the study were interviewed to assess their Emotional quality of life. Results: The female caregivers painfully construe caregiving as sadness and also attribute caregiving to be the source of their sadness in life. Somewhere there is a fatalist attitude adding greater pain in their life and they cope with pain and sadness largely by crying. On the other hand, male caregivers have reported painful and conflictual relationship with the patient as the perceived meaning of sadness and pain both. However, they cope up with the same by moving away and sharing with people. Globally the self-image of the caregivers is negative more specifically after the caregiving. The narratives of the caregiver are subsumed in a model. Conclusions: The findings of the study serve as the roadmap for furthering researches into emotional wellbeing of the caregivers of the person with chronic mental illness. Largely the attention is more towards creating intervention for the patients suffering from mental illness. Such studies would serve as the base for creating and improved emotional Quality of life for the caregivers.