Introduction: The Corona Virus Disease 2019, caused by novel Coronavirus SARS-CoV-2 is an acute respiratory and systemic illness, and is declared as a global pandemic by WHO on the 11th of March 2020.Only 2.2% to 1.7% of pediatric COVID-19 cases have been reported from USA and China respectively. The hematological parameter alteration in the pediatric COVID-19 cases needs to be addressed in the Indian population. Aim: To assess the alteration of the baseline hematology parameters in the paediatric COVID-19 cases and to compare the values with the adult COVID-19 cases for any statistically significant difference. Methods: A single Centre retrospective study of 11 COVID-19 asymptomatic pediatric patients and asymptomatic gender-matched adult cases admitted to SSPH&PGTI NOIDA from March to April, were enrolled for the study. The demographic date, baseline hematological findings of both groups were recorded and analyzed statistically. Results: Demographic characterization shows a mean age of 8.7 years in the pediatric population. Baseline CBC findings of all the pediatric cases show mild anemia, normal leucocyte, normal absolute lymphocyte count, and neutrophilia.- Majority of the pediatric cases have NLR value below the cut-off point of 3.13.- PLR was slightly higher in pediatric cases. Comparison between two groups shows statistically significant differences for the hemoglobin and platelet value only. Conclusion: The comparative analysis of baseline hematologic parameters did not show any significant derangement of the CBC parameters in pediatric cases. Significance in the difference of Hemoglobin level and platelet count is observed in comparison to the adult cases.

Background: In India more than 50% of general hospital skin out-patient attendance consists of infections which are acute and usually recurrent like Scabies, Pyodermas, Superficial fungal infections, Parasitic and viral infections, Eczemas, Acne, Vitiligo, Pigmentary changes, Psoriasis, Lichen planus, Leprosy etc. The present study was therefore designed with the aim of studying the histopathological features of various skin diseases. So that, the clinicians can manages the case efficiently. Aims & Objectives: To find the clinicopathological correlation and to study the histopathological features of Non-neoplastic skin lesions. Materials & Methods: A total of 93 skin biopsies either Punch or Incision biopsies which were received in the department of histopathology were stained with Hematoxylin& Eosin, and studied microscopically. Results: Out of 93 cases, only 20 (21.5%) cases are not similar in clinical diagnosis and histopathological diagnosis but remaining 73 (78.5%) cases has similar diagnosis both clinicopathologically. Conclusion: histopathological study and comparing the clinical diagnosis serves as a very valuable diagnostic tool to understand and explain the pathology of various skin lesions.

Cylindromas are rare slow growing benign skin appendageal tumors with eccrine and apocrine differentiation. Multiple cylindromas are commonly genetically inherited and also known as “turban tumor.” Here, we have discussed a case of scalp swelling in a male patient having lung cancer, which was clinically suspicious of metastasis. However, cytology revealed many clusters of small round to oval basaloid cells surrounded and attached with magenta coloured acellular hyaline material. The cells had very scanty cytoplasm and dark, round to oval hyperchromatic nuclei without any nuclear membrane irregularity. Cytologic diagnosis of cylindroma was rendered which was subsequently confirmed on histopathology. Cytology of cylindroma should be differentiated from adenoid cystic carcinoma and other benign adnexal tumors like spiradenoma. We wish to report this case as cytology of dermal cylindroma has rarely been dicussed previously in literature and to highlight its cytomorphologic features along with the differential diagnosis.

The purpose of this study is to examine the effect of external, internal and managerial risks on firm value. External risk is proxied by carbon emissions disclosure and environmental performance, internal risk is proxied by enterprise risk management disclosure, while managerial risk is proxied by leverage. The study was conducted on non-service industry companies listed on the Indonesia Stock Exchange. The sampling technique used was purposive sampling, with criteria for companies that had a PROPER rating for the 2017 and 2018 periods of 64 companies. The results showed that the PROPER rating and leverage affect on firm value, while the carbon emissions disclosure and enterprise risk management disclosure do not affect on firm value. The inability to prove the effect of both disclosures can be caused by the element of subjectivity in its measurement. This result proves that investors take into account external risks in the form of environmental performance based on PROPER ratings and leverage as manifestations of managerial risk. Thus, the results of this study prove that investors recognize the accountability and independence of PROPER assessments.

This work is part of the fight against in vitro the growth of Lasiodiplodia theobromae with some medicinal plants including Aloe vera, Moringa oleifera and Newbouldia laevis. This fungus causes brown cocoa rot in the Kisangani region. The antifungal activity of the crude, aqueous, ethanolic and ethereal extracts of fresh and dried leaves of the plants studied were evaluated in vitro by six repetitions on Potato dextrose agar medium. After two days of incubation, the raw extract of the fresh leaves of M. oleifera inhibited the growth of L. theobromae by up to 74.1% followed by that of A. vera (29.6%) and N. laevis (14.7%). The aqueous, ethanolic and ethereal extracts of the fresh leaves of M. oleifera revealed respective inhibition percentages of 43.0; 53.3 and 71.1. As for the extracts of the dry leaves, A. vera was active with its ethereal extract (58.1%) and ethanolic extract (56.7%). Notwithstanding, M. oleifera remains the very active plant with an excellent inhibition rate of 74.1% having considerably slowed down the maximum growth time of L. theobromae by reducing it from two days for the control to six days for the raw extract. Although the plant extracts studied have a fungistatic effect, their purification by extraction of phytochemical groups in our next studies, could reveal their respective fungicidal properties.

Government of Nepal has been planning to develop modern cities through land pooling programs as per the Town Development Act 2045. The study is conducted in Ichangu Narayan (Raniban) Land Pooling Project phase II and the status of variation orders, their origin, causes and impacts in project cost and completion time is analyzed to develop preventing measures which can be beneficial in upcoming similar projects. The objective of the research was to identify the types of variations and the origin and rank, to assess the impact of variation orders regarding cost and duration and to explore the preventive measures to minimize the variation orders. Primary data were collected from the questionnaire survey, key informant interview and field study. The secondary data were collected by means of desk study, relevant literature and text books review, maps and drawings and internet sources. From the study, main cause of variation orders impacting project completion time is known to be conflict between the contract documents and is originated from Consultant. Similarly, main cause of variation orders impacting project cost is additional work. 26.50% (Rs 45,700,255.02) cost above the contract cost has been incurred directly at the completion of the project. 12.40% (Rs 21,380,129.70) of contract cost has been paid for price escalation only. Similarly, 16.96% cost for the successive contract of the project has been increased by the extension of the contract duration. The appropriate recommendation has been given to the concerning parties involved in the construction work.

Introduction: Scabies is a common contagious parasitic dermatosis. Transmission of the mite Sarcoptes scabiei var hominis generally occurs by skin-to-skin contact, but with crusted scabies it may also occur through fomites, such as infected clothing or bedding. Diagnosis is usually clinical. Objective: To find out The Management of Scabies Infection among the Outdoor Patients of BIRDEM General Hospital, Dhaka, Bangladesh. Materials and Methods: Scope and Delimitation of the Study. This study focused the management of scabies. This study was conducted among the OPD patients in BIRDEM hospital. The study was conducted from January to December 2017.The diagnoses of scabies of the potential respondents were based on the set criteria. Only those diagnose clinically with scabies were included in this study. There were no scraping procedures (acarus test) done to confirm the diagnosis of scabies. Other skin diseases aside from scabies were not included in the study. Results: A 2017 updated Cochrane review concluded that management of scabies is based on topical scabicides, mainly 5% permethrin. However, oral ivermectin, although not licensed in many countries, may be useful, particularly for patients who cannot tolerate or comply with topical therapy and in institutional scabies epidemics. Patients should also receive detailed information about the infestation to limit further spreading. Cases resulting from close physical or sexual contact, even without symptoms, should be systematically treated. Hygienic measures should be taken after treatment is completed. Patients should be followed to confirm cure, including resolution of itching, which may take up to 4 weeks or longer. Conclusion: At the end of this study, the researcher was able to arrive at the following Conclusion Scabies is more common where overcrowded conditions prevail; it can affect any individual irrespective of social status, personal hygiene, profession, gender, age or ethic origin. These include increased number of household members, presence of other family members with scabies, overcrowding, poverty and low educational attainment. Children (l-12 yrs.) have the highest incidence of scabies as compared to the other age group.

The construction industry in Nepal is an important sector due to its enormous contribution to the country’s economic development. This in terms of employment opportunities and attraction of Foreign Direct Investments which grossly contributes to the country’s GDP. Due to various factors many construction projects are prone to delay. These delay factors can only be avoided by first identifying the factors and their sources. The objectives of this research were to find out the causes of delay and to find related importance in completed Road construction projects in SNRTP in Gandaki province in Nepal. The Relative Importance Index (RII) was used to rank the causes of delay. Similarly, reliability of research instrument was calculated using Cronbach’s coefficient alpha. The results obtained indicate that the top major causes of delay were; weather and climatic condition (RII=0.898), delay in decision in relocation of service (RII=0.886), long chain of hierarchical decision making process (RII=0.885), land acquisition/donation (RII=0.884), inaccurate time estimation, errors during construction (RII=0.884), conflict between joint ownership of the project (RII=0.872), poor communication and coordination between the participants (RII=0.836), lack of database and experience for estimating activity duration and resources required in a construction (RII=0.818) ,owner’s lack of experience and involvement (RII=0.809), shortage of materials /equipment (RII=0.807), improper project document management (RII=0.800), to least ranked consultant’s reluctance for change and their flexibilities (RII=0.722) .Finally the top major delay mitigating measures were; Information sharing and Joint risk management, Enhancing Contractual management and administration capability, Making timely decision in project, Managing sufficient time and allocation of adequate team for project preparation, Completing pre-execution preparation of project before project starting, Investigating/studying the site properly, strengthening the skill/capability of human resources and selecting better Time for contract.

Postmenopausal women are at risk of cardiovascular disease due to the cessation of estrogen hormone secretion by the ovaries. Based on a few studies in the western population, the plasma homocysteine level has been shown to be a more reliable indicator of cardiovascular risk in elderly women, when compared to conventional markers like lipid profile. However, not many studies have been done in India regarding the role of homocysteine and lipid profile as a risk factor in causing the cardiovascular disease in postmenopausal women. Objectives: 1. To estimate plasma homocysteine and lipid profile levels in pre and post-menopausal women. 2. To compare and correlate homocysteine and lipid profile levels in pre and post-menopausal women. 48 confirmed cases of postmenopausal women and 48 regularly menstruating premenopausal women were included in the study after screening for inclusion and exclusion criteria. Blood samples were collected from the subjects and processed for estimation of lipid profile and plasma homocysteine levels. The BMI was significantly higher in the postmenopausal women as compared to premenopausal women. There was no significant difference in the mean values of lipid parameters between the two groups. The mean plasma homocysteine level (19.93 ±8.09) was significantly increased in postmenopausal women when compared to premenopausal women (10.52 ±2.62) and it also showed a positive correlation as age advances age. In our study we found that, there is a significant increase in homocysteine levels than lipid profile parameters, hence homocysteine may be consider as a sensitive marker of CVD’s in postmenopausal women.

Two months after the World Health Organization (WHO) has declared the COVID-19 as a pandemic, near 3.7 million people were confirmed positive to the coronavirus, with 253.831 deaths. While Mankind fights desperately for survival in a critical moment in human history, most teachers had to reinvent themselves in a joint effort to avoid a complete halt in educational activities; suspended sine die around the globe. This article investigated the challenges faced by teachers, and executive education professors in Brazil, through live online classes via the Zoom platform. Key findings pointed out (i) the lack of stable online connection; (ii) security issues; (iii) limited pedagogical resources; (iv) background noises; (v) shortage of equipment supply due to the lockdowns, as barriers to online live classes dispensed with the Zoom platform. This study aims at providing scholars, teachers, professors, instructors, practitioners, online service providers, software developers, among others, with a perspective regarding the online live education experience. We also compared live virtual with classroom teaching, promoting the debate on the implications and best practices.

Adipose tissue and lipomas are very rare in the paranasal sinuses. Here we report a case of 14 years old male presenting with history of nasal obstruction, excessive sneezing and mouth breathing who was eventually diagnosed as maxillary antrum lipoma. It is a very rare finding and very few cases have been reported till date.

Background: Escherichia coli is one of the commonest pathogens causing community acquired Urinary Tract Infection (UTI). Increase in resistance to antibiotics and limited option of oral antibiotics for UTI calls for search for better alternative options. Extended Spectrum Beta Lactamase producing E. coli (ESBL- EC) further reduces the therapeutic options complicating the management. Nitrofurantoin (NIT) is one of the commonly prescribed oral drugs and Fosfomycin (FO) though an old drug is regaining its medical importance. The aim of the study was to study and compare the sensitivity of NIT and FO in ESBL-EC causing UTI. Material and Method: A total of 215 mid-stream urine samples showing growth of E. coli were collected and ESBL-EC identified. Antibiotic sensitivity testing was done by Kirby Bauer disc diffusion method as per CLSI 2019 guidelines using NIT (300μg) and FO (200μg) discs. The results were compared. Result: Out of 215 urine sample, 57(26.5%) isolates showed resistance to NIT while FO resistance was observed only in 11 (5.1%) of the isolates. Amongst isolated E. coli, 122 (56.7%) were extended spectrum beta lactamase (ESBL). Among the resistant isolates, ESBL producers were 45.5% (5 out of 11) and 57.8% (33 out of 57) for FO and NIT respectively. Conclusion: Increase in resistance trend in NIT calls for search of other oral options for treatment and FO promises to be one of them.

Confucianism was born twenty-five centuries and has lasted for so long over a wide area including China, Korea, Japan and Vietnam. That is one thing that needs to explain why. Explaining this would certainly be difficult to convince if the mere theory of its richness and depth. It must have the conditions to be born and exist in the socio-economic base of East Asia, first of all in China, where it was born. The conditions for its birth only exist in China, but the conditions for its long-term survival are in all three countries of Korea, Japan and Vietnam and must be similar to those in China, at least about culture generally. In the history of Vietnam, since independence, the feudal dynasties of Vietnam have begun to use Confucianism was an effective way to govern and manage society. It is not surprising that the laws enacted by the feudal dynasties of Vietnam all have Confucianism imprints. Those were ancient laws code; the most typical was built and issued in Vietnamese history (from the 11th century to the 19th century). Based on the study of ancient bibliographies, in consultation with researchers and colleagues, this study provides insights and assessments of the Confucian imprints in the Hoang Viet Luat Le (called the Gia Long law) of Nguyen Dynasties of Vietnam; It also raises some controversial issues about the position and role of Confucianism in the history of Nguyen Dynasty Vietnam so that colleagues and researchers continue to study and debate.

Although the stimulating effect of thyroid hormones on energy metabolism has been known for about a century, the relationship between thyroid function, weight control, and obesity is unclear. Objective: Our work aims to bring a focus on the association between obesity and thyroid pathology. Methods: A descriptive and retrospective study of all obese patients who had consulted or been hospitalized in the Department of Endocrinology, Diabetology and Nutrition at University Hospital Center Hassan II in Fez, over a period of 2 years from January 2016 to December 2018. All patients with a BMI ≥ 30 kg / m2 were included. The data were plotted on a table in the Excel 2010 program and analyzed using the SPSS 18 program. Results: 150 patients met our criteria, their mean age was 45.26+/-12.77 years with a female predominance (sex-ratio = 1/25). 10.66 % of our patients had dysthyroidism; among them hypothyroidism was individualized in 56.25% of cases. In this category, the serum TSH concentrations were positively correlated with BMI (p=0.011) and a significant weight loss was objectified after the start of hormonal treatment. While hyperthyroidism was present in 43.75% of our patients, 57.14% had morbid obesity and the response to weight gain after radical treatment (iratherapy or surgery) was minimal. Conclusion: Obese patients may develop thyroid dysfunction and even thyroid dysfunction may contribute to the gradual increase in body weight, resulting in overt obesity.

Final diagnosis of thyroid lesions requires morphological examination for which FNAC and histopathological examination become mandatory tests. In our study preoperative FNAC on 100 patients and along these histopathology reports of 22 patients were correlated and conclusions drawn after statistical analysis. Results: Diagnostic categorization of FNACs based on Bethesda classification showed that of the benign lesions (category 2), 45were Nodular colloid, 13Hashimoto thyroiditis, 13multinodular goitre, 3Primary hyperplasia and 2Hyperplastic nodule 1was of de-quervans thyroiditis, 1was of adenomatous goitre. Of the12 malignant lesions (category 6), 7were papillary carcinoma, 2anaplastic carcinoma, 1medullary carcinoma, 2 metastatic carcinoma on FNAC, 8 were suspicious for follicular neoplasm (category 4) and 1 was of follicular lesion of undetermined significance on FNAC (category 3). Among 100 cases, 22 were biopsied and subjected to histopathology. 11cases were benign. Out of these, 2 were of colloid goitre, 3follicular adenoma, 3multinodular goitre 2 was of hasimoto’s, 1 was of thyroglossal cyst. 11 cases were malignant, Out of these, 6 were papillary carcinoma, 3 were Follicular carcinoma and 1 medullary carcinoma 1 case of noninvasive follicular thyroid neoplasm with papillary like nuclear features. Out of 22 cases examined hitopathologically findings were similar to FNAC in 21 cases and findings differed in 1 case. The sensitivity & specificity for FNAC of thyroid neoplasm in present study were 82.6, 95.2%, respectively. Conclusions: FNAC is simple, safe & cost effective modality in investigation of thyroid swellings with high accuracy. The bethesda system of reporting has high concordance with the histopathological findings.