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.

The emergence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes coronavirus disease (Covid-19) pandemic has made it a universal health difficulty in both developed and developing countries, spreading fears, uncertainties and death. Worldwide, the disease is skyrocketing, spinning from a total of 124, 719 cases in 118 countries on March 12, 2020 to a high of 1,004,336 cases in 204 countries on April 2, 2020. Out of the 1,004,336 confirmed cases, 704,570 (95%) are categorized as mild cases 37,710 (5%) serious cases 51,556 deaths while 210,500 have recovered. SARS-CoV-2 belongs to beta coronavirus; usually these viruses form a polypeptide after genome transcription that needs to be cleaved enzymatically in order to produce non-structural proteins, this process is only possible with synergistic functions of Main protease or 3-chymotrypsin-like protease (3CLpro) and Papain-like protease (PLpro). Inhibiting these proteases will in no doubt interfere with replication and subsequent release of viral progenies. The current in silico study was performed to predict the possibility of 7 phytochemicals from Carica papaya as potential inhibitors of Covid-19 proteases and RNA dependent RNA polymerase. The protein structures and ligands were downloaded from RCSB Protein data bank (pdb) and PubChem respectively. The qualitative assessment of physicochemical properties, liphopilicity, water solubility, medicinal chemistry, drug likeness and ADMET were predicted virtually using swissadme. Molecular docking analysis showed that kaempferol, quercetin have good binding affinity and hydrophobic interactions with both Covid-19 proteases and RdRp. However, this hypothesis would be used as a background which needs to be proven otherwise in vitro.

Constitutions of new countries are expected to facilitate extradition relations as well as other modalities of international judicial cooperation with other countries. This is specifically important for countries, such as Somaliland, which seek recognition of their independence. However, in some cases, their Constitutional provisions do not succeed in materializing the right balance between national interests and the interest in fighting crime at the international level. As a result, the Constitution of such countries may even hurdle efficient extradition relation and eventually, isolate the country from the joint struggle against crime. This seems to be the case of Article 35 (3) of the Somaliland Constitution, in particular. This research paper is designed to explain the weaknesses of the aforementioned Paragraph 3 and provide some ideas for its improvement.

Aasavikarana is an age-old technique used in Ayurvedic Pharmaceutics. It dates back to “Rig Veda” which indicates the use of Soma and Sura which has been used in different medicinal preparations, surgical procedures and in many chemical and alchemical operations. Asava Arishtas (medical tincture), and Shukta (acidic fermented product) without doubt is one of the most potent medicinal formulations. Among many other reasons, one cause for its extraordinary performance may be the method of phytochemical extraction from it. The technique of microbial maceration of phytochemical extraction is inviting much attention in nutraceuticals due to its high yield, convenient, energy-saving and cost effective. Aasavikarana is a complex pharmaceutical process of microbial maceration and various other chemical processes like fermentation, Maillard reaction, hydrolysis of polymers and formation of antioxidant species. An effort is made to enlighten the process of microbial maceration in Aasavikarana and their effect on formulations in the present article.

Shankha (Conch) is one of member of Sudha varga (A class of calcium containing compound). It is used in various stomach ailments from many centuries. Shankha Bhasma (Conch Ash) is chief ingredient of many formulations. Physical and chemical characterization is fundamental step to understand the importance of determining efficacy and evaluating the clinically approved medicines of Tradition and complementary medicine (TCM). The physical characterization of Conch Ash was done by using X-ray diffraction (XRD), Scanning Electron Microscopy (SEM-EDX), and Fourier Transform Infra-red (FTIR) and particle size analysis by sieving technique and composition of heavy metals and its limits was determined using by Atomic absorption spectroscopy (AAS). For chemical characterization pH, Loss on drying, total ash, Acid insoluble ash, Water soluble ash was performed. The results revealed that Bhasmikarana (Incineration) process use in preparation ultimately changes the most stable polymorph of calcium carbonate of Shankha aragonite form into calcite from, along with formation of Portlandite and Lime in majority. FTIR spectra also confirm this assertion. Cubic-like calcite crystals of Conch Ash and rod-like aragonite crystals of conch shell powders were observed by SEM. The prepared formulation has nanoparticles with the average particle size ranging from to 62-90 nm as estimated using SEM and crystal size analysis by XRD.

Advanced cervical cancer results in infiltration of adjacent organ structures and can be complicated by severe bleeding. Endovascular embolization is a life-saving therapeutic option. This case highlights a unique presentation of a severely bleeding recurrent cervical cancer infiltrating the rectum in a patient with prior hysterectomy. Arterial supply to the tumor was almost exclusively supplied by the superior rectal artery originating from the inferior mesenteric artery. She was successfully treated with selective endovascular embolization using 500 micron particles. The patient had immediate resolution of severe bleeding, no procedural-related complications, and reduced recurrence of bleeding on long-term follow-up.

Acetaminophen is the most prevalent, deliberately ingested medication in overdose episodes and a key cause of acute liver failure. N-Acetylcysteine (NAC) is used to treat an overdose of acetaminophen. Using NAC may cause rare fatal adverse events which could affect the safety of the patient. Generally, the type and frequency of NAC related events are too minimal to be considered as an adverse reaction. It is necessary to examine the route of administration, method of reaction detection and the nature of the reactions. These events does not preclude patients from receiving this hepatoprotective advantage, particularly in the context of significant acetaminophen ingestion. We present our case and highlight the clinical inference which can be derived from this entity.