This study aims to determine the effect of corporate governance mechanisms on fraud in financial reporting. The sampling technique used was purposive sampling. This research was conducted at non-financial companies with a research time period (2015-2017). The estimated model used is logistic regression analysis. The purpose of this study is to determine whether corporate governance mechanisms influence fraud in financial reporting. This research involves 2 (two) variables consisting of 1 (one) dependent variable, 2 (two) independent variables. The dependent variable in this study is fraud in financial reporting. The independent variables in this study are the audit committee and leverage. The results of the research conducted in the regression analysis are 11.5% of the corporate governance mechanism variables against fraud in financial reporting. This means that corporate governance mechanisms simultaneously influence fraud in financial reporting.

Nursing profession is full of hazards. Health care worker faced all kind of hazards including biological, non-biological hazards, physical environmental, electrical, chemical hazards. A health care professional are at risk of these hazards. Among physical hazards back pain is more common. WHO provide a modal in 2010 for healthy work place. There are four avenues of this modal are: The physical work environment 2. The psychosocial work environment 3. Personal health resources in the workplace 4. Enterprise community involvement. There are many reasons for these hazards like Poor work organization, lack of awareness and competency of dealing with the equipment, heavy work load, lack of proper rest, poor diet, strict manager. Sufficient literature review is given for these hazards and their managements. In this study we discuss what are common hazards that are faced by health care worker and how they control.

This study aims to test the effect of Current ratio empirically, Return on Assets, Debt Ratio, Dividend Payout Ratio, and Price Book Value on Financial Distress. Causal correlation research methods. The sample selection in this study uses the Purposive Sampling method, so the criteria selected six mining sector companies. The data analysis method used in this study is the panel data regression method and found that the more appropriate model to use is the fixed effect. Based on the calculation results of the random effect model, the results of this study stated Current ratio, Return on Assets affect financial distress while Debt Ratio, Dividend Payout Ratio, Price Book Value do not affect financial distress.

Facial nerve schwannoma is an uncommon benign tumor, which is rarely encountered in the parotid gland, and mimicking the tumors of this gland. It’s a neurogenic lesion that arises from Schwann cells of peripheral nerve sheath. Most of cases, it is localized in the intratemporal segment of the facial nerve, only 9% that occur in the extratemporal segment. Intraparotid facial nerve schwannoma was firstly described by Ibarz in 1927. Even if the tumor arises from the nerve itself, the function of the facial nerve is generally unaffected. If there is facial paralysis, it is interfered with malignant parotid tumors. Because of the heterogeneity of imaging features, it is difficult to diagnosis and differentiate preoperatively the intraparotid facial nerve schwannoma from other parotid tumors, so the definitive diagnosis is made by histological examination of resected tumor. The management of intraparotid facial nerve schwannoma is a very contested issue within the literature. Because the benignity and low evolutionary potential of the tumor, some authors advocating a conservative attitude with clinical surveillance for patients without facial nerve dysfunction or for tumor localized in the parotid gland. However, if a severe or a sudden facial nerve dysfunction, or extension into the mastoid was founded, the surgical resection of the tumor is indicated without delay. We report a case of a 24-year-old young female, complaining of a slow-growing and painless mass in the left parotid area, associated with grade V facial paralysis on left side since 10 years. No lymphadenopathy was founded in the neck. The computed tomography scan was revealed a heterogeneous tumor, involving in superficial and deep lobes of the left parotid gland, and extending into the parapharyngeal space. On surgical exploration, the dissection of facial nerve and isolation of the mass was impossible. Because the patient had a facial paralysis preoperatively, we had to sacrifice the facial nerve to remove

The major purpose of economic instruments is to control pollution by harnessing the power of market incentives. Against this background, this paper examined and assessed the use of economic instruments for environmental sustainability in the Nigerian oil and gas sector. The political economy method was adopted to illuminate the issues surrounding the use of economic instruments in Nigeria. The study found that the use of economic instruments has not been effective in the Nigerian oil and gas sector. This was due mainly to inadequacies of economic instruments in use. The study thus recommended a combination of command – and – control tools and market based instruments to combat environmental problems in the oil and gas sector. Also, the government should muster sufficient will and determination to enforce the content of the Gas Flaring (Prevention of Waste Pollution) Regulation 2018.

Introduction: Sickle cell anaemia is a monogeneic hereditary disease that manifests as a lifelong multisystemic disorder characterized by periods of relatively stable health punctuated by periods of acute ill health, mostly possibly reversible and an accumulation of chronic complications, mostly irreversible affecting various organ systems with an outcome of persistent morbidity, and the risk of premature mortality. The aim of this study is to identify electrocardiographic changes typical to patients with Sickle cell anaemia (SCA). Method: Fifty three SCA patients and fifty three apparently healthy, age and sex matched adults HbAA subjects were recruited in this case control study. Individuals with other cardiovascular risk factors were excluded from the study. All recruited individuals were evaluated using electrocardiography. Result: There was left and right atrial abnormality in 7.4% and 3.8% of the SCA patients respectively while shortened PR interval was identified in 1.9%. First degree atrioventricular block was noted in 3.8% while features of Right bundle branch block (RBBB) and left bundle branch block (LBBB) were found in 3.8% and 1.9% of SCA patients respectively. Both Left and Right Ventricular hypertrophy with significant ST-T wave changes in the anterior and inferior leads were also observed in the SCA patients (p=0.001). Prolonged QTc was also identified in 20.8% SCA patients (p=0.02).CONCLUSION: Varied ECG abnormalities are common in SCA patients which may contribute to sudden death. Early ECG findings make for timely intervention towards prevention of disease progression.

Background: Psychological stress adversely affects immune function, potentially influencing cancer progression and patient outcomes globally. Objective: This study aims to evaluate the impact of stress on the immune system of cancer patients in Al-Ahsa, Saudi Arabia, and its correlation with disease progression and treatment response. Methods: A cross-sectional study was conducted in Al-Ahsa during 2019, enrolling 1,000 cancer patients. Stress levels were assessed using the Perceived Stress Scale (PSS). Immune parameters, including cortisol levels, natural killer (NK) cell activity, and cytokine profiles (e.g., IL-6, TNF-α), were measured through blood samples. Statistical analysis was performed using SPSS version 26.0, employing descriptive statistics, Pearson correlation, and multivariate regression to examine relationships between stress and immune markers. Additionally, Receiver Operating Characteristic (ROC) curve analysis was utilized to determine the predictive accuracy of stress on immune dysfunction and clinical outcomes. Results: High stress levels were reported by 68% of patients. Elevated cortisol was observed in 72% of highly stressed patients compared to 28% in low-stress groups (p < 0.001). NK cell activity was significantly reduced in stressed patients, with a mean decrease of 35% (p < 0.001). IL-6 and TNF-α levels were elevated in 65% and 60% of patients experiencing high stress, respectively (p < 0.001). Multivariate analysis revealed that stress independently predicted reduced NK activity (β = -0.45, p < 0.001) and increased pro-inflammatory cytokines (β = 0.50, p < 0.001). Additionally, stress was associated with a 20% higher rate of disease progression (OR = 1.20, 95% CI: 1.05-1.37) and a 15% poorer treatment response (OR = 0.85, 95% CI: 0.78-0.93). ROC analysis demonstrated that the PSS score had an area under the curve (AUC) of 0.82 (95% CI: 0.78-0.86) for predicting immune dysfunction. The combined effect of high stress and immune dysregulation contributed to a 25% increase in overall mortality risk (p < 0.05). Furthermore, subgroup analysis indicated that females exhibited a higher prevalence of stress-induced immune alterations compared to males (75% vs. 62%, p = 0.004). Conclusions: Stress significantly impairs immune function in cancer patients in Al-Ahsa, Saudi Arabia, correlating with increased disease progression and diminished treatment efficacy. These findings underscore the necessity for integrating stress management interventions in oncology care to enhance patient outcomes.

This study is entitled the meaning of "small step gives a change" version of ADES corporate social responsibility advertisement in television media. The purpose of this study is to uncover the meaning contained in an advertisement. This research is expected to give scientific contributions for all parties that have an interest in communication practitioners. In addition, this research also hopefully gives contributions of thoughts relating to the application and advertisement creation that have the right meaning and message through the audio visual language of CSR advertisements in television media, so that the Advertising messages can touch the rational and emotional aspects of the audience. The method used in this research was a semiotic analysis method of Charles Sanders Pierce. The object of study in this study was the ADES mineral water advertisement of "Small Step Gives a Change" version in television media which has seventeen seconds time duration. Based on research that has been obtained on the results of research and discussion on the meaning of the messages contained in the ADES mineral water advertisement of "Small Step Gives a Change" version on television media, it can be concluded that through the finding of signs in Ades advertisement, it was implied a message about the environment care. Ades wanted to show that the mineral water had a high quality and gave solutions to the public in protecting the body. Broadly speaking, the advertisements' meaning show the commitment of Coca-Cola Amatil Indonesia towards sustainable packaging. The sustainable means that through the environmentally and friendly ADES packaging, it can have a positive impact on the environment sustainiblity.

Background: Pterygium is a triangular fibrovascular subepithelial in growth of degenerative bulbar conjunctival tissue over the limbus on to the cornea. Pterygium typically develops in patients who have been living in hot climates and may represent a response to chronic dryness and ultraviolet exposure. Methods: This prospective study included 70 patients with primary pterygium, randomly divided into two groups: Group A treated with conjunctival autograft and Group B with intraoperative mitomycin C. Standard preoperative evaluation, surgery under local anesthesia, and postoperative follow-up up to 6 months were performed to assess visual outcomes, complications, and recurrence. Results: A total of 70 patients with primary pterygium were divided into two groups: Group A (conjunctival autograft) and Group B (mitomycin C). Most patients in Group A were aged 31–40 years (40%), while Group B had more in the 51–60 range (28.6%) (p=0.018). Males predominated in both groups. Visual acuity improved in both, with 6/6 vision in 37.1% of Group A and 28.6% of Group B at 6 months. Complications were fewer in Group A (11.5%) than in Group B (54.3%), making conjunctival autograft the safer and more effective method. Conclusion: The study of 70 eyes with primary pterygium showed that conjunctival autograft had fewer complications and a lower recurrence rate (2.9%) compared to intraoperative mitomycin C (14.3%), proving it to be a safer and more effective method for managing primary pterygium.

Background: Drug utilization studies conducted at regular intervals help to guide the physician in prescribing drugs rationally. Methods: This is prospective, observational study was conducted in the outpatient of department of general medicine of Indian Institute of Medical Science & Research a tertiary care teaching hospital. Data was collected from patients who have been diagnosed with hypertension as per JNC-8 guidelines and patients receiving or prescribed with antihypertensive medications were included. Frequency and proportions of utilization of antihypertensive medications in were figured. Results: A total of 170 prescriptions were analysed during the 6 month study period. The patients 93 (46.5%) were on Mono therapy significantly higher than dual therapy, triple therapy and poly therapy, 64 (32 %), 27 (13.5%), 16 (8 %) respectively. Calcium channel blocker was the frequently used class of drug for monotherapy (19.5 %). In dual drug therapies were CCB+ARB accounting for 18.5 %, and 5.8% of patients were on triple drug therapy with CCB+ARB+Diuretic. 30.2% patients were on ACE inhibitors. 25.5 % patients receiving Calcium channel blocker reported side effect. Conclusion: This type of studies gives the base line idea of prescription pattern and ADRs of antihypertensive drugs. These helps to design policy for rational use of drugs and motivation of physician for rational use of drugs. The study emphasizes that need for effective continuing medical education and also preventive measures in hypertensive individuals.

Background: Central line-associated bloodstream infections (CLABSIs) are significant healthcare challenges, associated with increased morbidity, mortality, and healthcare costs (Magill et al., 2014). Nursing care plays a crucial role in preventing these infections. Objective: This study investigates the impact of nursing interventions on central line care and CLABSI rates in patients admitted to Imam Abdulrahman Bin Faisal Hospital, Dammam, Saudi Arabia. Method: A prospective observational study was conducted from June 2018 to June 2019 with a sample size of 100 patients with central lines. Nursing interventions included daily line assessments, sterile dressing changes, and strict adherence to hand hygiene protocols. Data on CLABSI incidence were collected and analyzed to determine the association between nursing care quality and infection rates. Result: Among 100 patients, 15 developed CLABSIs, yielding a 15% infection rate. Patients with consistent nursing interventions had a 7% infection rate (3 out of 45), compared to 28% (12 out of 55) among those with inconsistent care, reflecting a 75% reduction with effective nursing practices (p < 0.05). Standardized dressing changes lowered infection rates by 40%, from 20% to 12%. Adherence to hand hygiene further reduced infections by 33%, from 15% to 10%. Units with nurse-patient ratios below 1:5 saw a 5% infection rate, significantly lower than the 18% in units with higher ratios, showing a 72% reduction. Conclusions: Effective nursing interventions significantly reduce CLABSI rates, underscoring the need for stringent infection control protocols and adequate nurse staffing. Enhanced nursing training and policy standardization are recommended to further minimize CLABSIs.

Objective: To study profile of accidental poisoning in 1yr –12 yr children admitted at Paediatric ward in Calcutta national medical college & hospital, (CNMCH) Kolkata from April 2018–March 2019 and their outcome. Method: All children admitted at CNMCH children ward from 1 to 12 year with accidental poisoning excluding all bites-including snake bite, scorpion sting etc. The age group, nature, type of poison, symptom complex & response to therapy were studied. Result: 201 children of 9 month to 12 year with accidental exposure to poisoning admitted in a tertiary care centre. Common age group affected in the study is below 3 yrs (75%).Boy child commonly affected & common poisoning was kerosene oil (52.2%) followed by turpentine oil (14.9%). Among medication, poisoning (4.97%) not only due accidental ingestion but due to overdosing. Other Rare causes of poisoning was Phenyl, Rat killer, Mosquito repellent/oil, bed bug killer etc. Mortality of the patient was 0.49 % .30% cases (>14 days) suffering was prolonged. PICU management was needed in 1.99% cases. Conclusion: Most common cause of accidental poisoning was kerosene ingestion in rural children. Male children of toddler age group was involved commonly.

Every year, over 250,000 patients have cardiac surgery and the incidence of cardiac arrest. When treated quickly, 17% to 79% of patients who experience cardiac arrest after cardiac surgery survive to discharge. Many of health care providers found this was disorganised and they would have performed better if they had well defined roles. Objectives: The aim of the study is to assess the level of knowledge among novice nurses regarding cardiac advance life support surgery (CALS) in cardiac surgery intensive care unit (CICU) and Cardio pulmonary department (D1 department) of Aga khan university hospital. Material and Methods: The descriptive cross-sectional study done. The 15 nurses were selected as sample to assess knowledge. Results: Novice nurses were not aware about (CALS). Moreover we developed module for nurses for future education and awareness about CALS the later study will help to assess the efficacy of CALS module. Conclusion: The study helps to make module of CALS for nurses taking care of patient underwent open heart surgery.

Background: Peak expiratory flow rate (PEFR) reflects the strength and condition of respiratory muscles and the degree of airflow limitation in large airways. PEFR is recorded in Mini Wrights Peak Flow Meter and it is commonly used for screening the individuals who are asthmatics. PEFR shows hour to hour variation that follows a specific pattern in asthmatics and healthy individuals. Circardian oscillations in the sympathetic activity may have impact on the airway smooth muscles. Materials and Methods: Peak expiratory flow rate was recorded in 60 young healthy females in the age group of 18-25years in Sri Ramachandra Institue of Higher Education and Reasearch. Mini Wright’s peak flow meter was used to measure the peak expiratory flow rate. PEFR was recorded at 6-7am, 9-10am, 1-2pm, 5-6pm, 10-11pm in a single day. Results: Our results showed PEFR values were low in the morning, followed by progressive rise peaking in the afternoon and evening and a small fall at night time. Highest PEFR is seen around afternoon. Conclusion: Comparing the PEFR readings there ia diurnal variation there is a diurnal variation in healthy young females showing a overall dip in the morning PEFR at 6 A.M, peaking in the evening PEFR at 6P.M, eventually decrease in night PEFR at 10P.M. But there is no significant in the afternoon (2P.M) and night (10.P.M).

Background: Gestational Diabetes Mellitus is considered to be a significant problem among pregnant women in Egypt. Aim: To evaluate the effect of educational protocol to improve pregnant women practices about gestational diabetes mellitus. Design: A quasi-experimental design was used. Setting: The outpatient diabetic clinic at Zagazig university hospital. Sample: A purposive sample of eighty pregnant diabetic women. Tools: Two tools were used in the study, Tool (1): Contained two parts; (1) demographic characteristics, (2) History about reproductive profile during pregnancy, Tool (2): Included two parts, assessment of knowledge of pregnant women about DM, and assessment of practice of pregnant women about DM. Results: The mean age of the pregnant women were 32.04 ± 9.36 years, also it was revealed that the total knowledge scores improved from 31.35% to 58.20%, with a highly significant difference (p=0.0044) for the participants, additionally, the overall increase in adequate practices improved from 56 to 78.5% after the implementation of the protocol sessions, with a significant difference (p=0.0106). Conclusion: The implementation of educational protocol for pregnant women was effective and enhanced their practices, and knowledge regarding the gestational diabetes mellitus. Recommendation: The study recommended that further studies for pregnant women with gestational diabetes mellitus should be applied in all health care centers.