Introduction: The Current 3 major LAC guidelines (BSH, ISTH & CLSI) recommends mixing tests for detection of LAC, even though these test order/ sequence vary & there are certain limitations, but still these guidelines advocates mixing test so as to maximize the diagnostic performance. The main objective of this study is to assess sensitivity of these tests in 255 LAC cases. Results: The Coagulometer used is Sysmex CS-5100. RI Cut offs ≤ 10 = Correction & ≥ 15 = Inhibitor & SNR > 1.15 indicates inhibitor. Of 255 LAC cases RI showed a sensitivity of 72% in correctly detecting LAC were as 11.7% were indeterminate & 15% were wrongly interpretated as factor deficiency. SNR showed a sensitivity of 83% in correctly detecting LAC were as 10.9% were indeterminate & 5.8% were wrongly interpretated as factor deficiency. Discussion: BSH & ISTH guidelines recommends Standardised Normalised ratio (mixing test-specific cut off) and Rosners index (ICA) for interpretation of mixing test results in detecting LAC.This study shows that SNR is more sensitive than RI for detecting LAC while interpretating Mixing test results. This study was in correlation with Moore & Kumano’s study. Conclusion: It is difficult to interpretate mixing study results in LAC patients. It is valuable to maximise mixing test interpretation as the dilution can lead to false-negative results .RI & SNR were comparatively analysed for their sensitivity to detect LAC in mixing studies & these data applied with the reagents and equipment employed, SNR was found to be more sensitive as compared to RI.

Mucoceles are common in oral cavity, but rare in pediatric patients. Diagnosis and management of mucocele is challenging. Surgical excision is an appropriate treatment modality with least recurrence and good prognosis. This is a case report of 12 year old with mucocele on the left side of the ventral surface of the tongue.

The paper explores theoretical justifications for granting patent monopolies in order to clarify the implications of existing patent doctrine and to have a theory for limitations to those patent rights.

Objective: The main aim of this study was to establish psychometric properties of the subscales self-realization and health responsibility of the health-promoting lifestyle profile II tool among Kenyan university students Design: The study design was a cross-sectional analytical, that utilized quantitative methods Setting. The study was conducted in Kakamega County, located in Western Kenya. Analysis: Data were analyzed through confirmatory factor analysis, which was conducted using robust maximum likelihood estimation. The factor model was tested for validity and construct validity. Main outcome measures: subscales self-realization and health responsibility of the Health-Promoting Lifestyle Profile II Results: The items for self-realization and health responsibility had a Cronbach's alpha coefficient of 0.72 and 0.80, indicating acceptable reliability. For self-realization, the results of the Chi-square goodness of fit test were significant, χ2(27) = 251.61, p < .001, suggesting that the model did not adequately fit the data. The fit indices showed the RMSEA index was greater than .10, RMSEA = 0.20, 90% CI = [0.18, 0.22], which is indicative of a poor model fit. The CFI was less than .90, CFI = 0.52, suggesting that the model is indicative of a poor model fit. For health responsibility, the results of the Chi-square goodness of fit test were significant, χ2(20) = 272.58, p < .001, suggesting that the model did not adequately fit the data. Fit indices values showed the RMSEA index was greater than .10, RMSEA = 0.25, 90% CI = [0.22, 0.27], which is indicative of a poor model fit. The CFI was less than .90, CFI = 0.75, suggesting that the model is indicative of a poor model fit. Conclusion: In conclusion, within the limitations of this study, the results showed that confirmatory factor analysis could not well fit the items to their latent constructs.

Background: Obesity is a complex, multi-factorial, chronic condition that is associated with mortality and significant morbidity and is prevalent worldwide. The aim of the study is to determine the effect of obesity on pulmonary function abnormality in young adults in our population. Method: A cross sectional study on 140 individuals, selected randomly from general population of Rajkot city was performed. A thorough history analysis (Height, Weight, BMI), Physical examinations Spirometry were done on all individuals after explaining the procedure and taking their consent. Parameters measured by the spirometer were FEV1, FVC, FEV1/FVC, PEFR, ERV, IC, EC, VC. Result & conclusion: It was observed that lung volumes decreased with statistically significant decreased ERV (0.66±0.09 L) & FVC (3.10±0.91) as the BMI increases (30-35Kg/m2). Negative correlation was found between BMI and ERV (-0.307) at higher BMI Values.

Background: Diabetes is a highly prevalent chronic disease and Bahrain is ranked amongst the top ten. Diabetes has many complications. Retinopathy caused by diabetes if considered number one leading cause of blindness world wild. This study explore the factors influencing the uptake of the Digital Retinopathy Screening Programs (DRGP). Methods: Five of the Primary Care centers in the country providing the (DRSP) have been visited on daily basis for two weeks in row and patients attending for the test have been questioned, defaulters were called and questioned through the phone for the causes. Results: A total of 367 type II DM patients were enrolled in the study with a (42.5%) are within the age range of 50-59. 75.2 % of the sample attended for the screening and were questioned and the remaining non attendees were questioned through the phone. A Comparison between the characteristics and reasons behind attendance and non attendance amongst the two groups was conducted statistically by SPSS using Chi Sequare test and Fisher’s exact test. Results using P-Value showed that the major reasons for non attending the appointments are forgetting the appointment, ignorance, neglect, some special circumstances like sickness or travel and miscommunication between patients and staff or physicians. While on the other hand, reminders and physician recommendations have show to be of a positive influence over patients’ attendance.

Introduction: Physical inactivity is a major contributor to the overall burden of cardiovascular disease such as storke, coronary artery diseases and other non-communicable diseases like type 2 diabetes, breast cancer, and colon cancer while Physical activity is a key and important factor that contributes to decrease the risk of cardiovascular disease. The aim of this study is to determine the prevalence and predictors of physical inactivity in a rural population in Nigeria. Methods: A cross sectional rural population study involving 572 subjects aged 15 years and above. Socio-demographic data were obtained by face-to-face interview. Weight, height, waist circumference, hip circumference measurements were taken along with blood pressure measurements. Blood samples were taken for fasting blood sugar and lipid profile. Results: Five Hundred and seventy two had their data analysed with male to female ratio of 1:2.6. The overall mean age was 39.08±17.5 years. The overall prevalence of physical inactivity in this study was 3 % to 7.3% during commuting or working respectively with men being more active than females. The elderly age group of 70 years and above were more sedentary than all other age groups. Pearson correlation and Spearman’ rho correlation analyses showed that smoking and BMI correlated with obesity. Linear regression analysis showed that smoking and BMI predicted presence of physical inactivity. Conclusion: Physical inactivity prevalence in this study is low with smoking and BMI being important predictors.

The present study attempts to locate women in the universal crime theories which seem to be developed from male subjects and validated on them too. Due to the increasing equality in status and opportunity between men and women the line between male and female crime is getting thinner. There are many universally accepted theories which apparently apply to male criminals but on lifting the veil on them and studying minutely we discover that they equally apply to female criminals too. No doubt any theory is weak if it does not apply to half of the population which experiences the same deprivations in the same environment, family structures and economic conditions. The research revolves around the twin factors, first that the theories of crime should be able to take account of both men’s and women’s behavior and to highlight those factors which operate differently on men and women and second that if a particular theory helps us to understand female crime better this would be a great achievement for criminology. The relevant matter for consideration is whether these ‘manmade’ and ‘made for men’ do explain female crime and if few of them or all of them do so then to what extent?

Back ground: Wood workers are more prone to exposed wood dust on regular basis. They are more prone to develop occupational lung diseases. PFT among such workers describe prognosis of such occupational hazards of wood dust. Aim: Based on such back ground we have conducted PEFR, FEV1/FVC and MVV among wood factory workers and compared with healthy individuals. Methods: Present study was carried out at Shree M P Shah Medical College, Jamnagar. We have used MEDSPIROR to collect PFT data in wood workers. Result: Wood workers have significant low PEFR (4.6±0.34), FEV1/FVC (87.98±3.66) and MVV (75.02±3.6) as compare to healthy individual. Prolonged exposure to wood dust in workers shows declining of PFTs.

Our study focuses on Congolese taxation in the face of the challenges of decentralization: the case of the province of Ituri from 2016 to 2018. We analyze the feasibility of the law regarding withholding tax by decentralized territorial entities. Thus, this study focuses on the following questions: is the withholding of revenue by the decentralized territorial entities carried out according to the spirit of the law in the matter for their development? If not, what are the consequences and possible solutions for the province of Ituri? The constant is such that withholding suffers from a systematic violation in the province of Ituri. The consequences are enormous and, moreover, too visible. This province is in an economic dependence on the central power, which consequently hinders its development. The solution to consider is compliance with article 175 of the constitution of the Democratic Republic of Congo which states that: "The share of national revenue allocated to the provinces is established at 40%. It is withheld at source. To verify, apprehend and guide this study, the documentary technique is probably for us more practical, explicit and appropriate in the realization of our modest work.

India is known for providing quality education to the world during the ancient times. The University of Nalanda was established in the 5th century AD by one of the Gupta emperors. The Chinese traveller Hieun Tsang had studied and wrote about the education system prevailing at that time in the university. The British Government made education a transferred subject in the constitutional Reforms in 1919. From then onwards education including university education became the responsibility of the States. Information Communication Technology (ICT) has become an important, valuable and critical resource for the university. ICT usage has become very common but its full potential is yet to be discovered. It is a helpful tool for creating good governance in the working of any organization. Recognizing the important fact that ICT (Information and Communication Technology) is a major vehicle for process change and an effective tool to transfer the entire governance, the policy makers are stressing hard for adoption of new technology. The interactive nature of ICT and its ability can help the citizen without wasting much time and money. With the introduction of Information Technology Act, 2000, transactions on the internet have got legal validity in India.

Medication therapy to Chronic Kidney Disease patients is complex because of the co morbidities and the major risk associated with these patients. A prospective, cross sectional study was conducted for a period of 6 months in a tertiary care hospital. A total of 130 patients, aged 18 years or older, diagnosed with all stages of Chronic Kidney Disease were included in the study. Patient data were collected from the patient medical records, the prescriptions were analyzed and the drug related problems were identified and classified according to Hepler and Strand. Descriptive analysis was done for age, gender, stages, drugs and Drug Related Problems. A total of 1454 drugs were prescribed for the patients with an average of 13.3±3.53 drugs per prescription. An average of 1.25±1.23 Drug Related Problems per prescription were observed among the study population. The most common Drug Related Problems identified was Adverse Drug Reactions (11.53%) and Drug combinations to use with caution and need close monitoring (11.53%), followed by over dose 9.23%. Other Drug Related Problems identified were untreated indication 7.69%, Drug without indication 3.08%, improper drug selection 1.53%, Treatment duplicity 0.76%, and potential Drug interactions 80.00%.Continual identification and resolution of Drug Related Problems in Chronic Kidney Disease could play a vital role in achieving better clinical outcomes.

Background: Amniotic fluid is a clear, slightly yellowish liquid that surrounds the fetus during pregnancy. It is contained in the amniotic sac. During pregnancy, it acts as a shock absorber, maintains even temperature, allows for growth and free movement of the fetus and prevents adhesion between fetal parts and amniotic sac. The aim was to study fetal and maternal out come in cases of low AFI and normal AFI. Methods: A hospital based Prospective comparative study was conducted in the Department of Obstetrics and Gynaecology, SMS Medical College, Jaipur from April 2017 to September 2018. Study conducted on 110 pregnant women at term (37-40 weeks) attending antenatal clinic. They were divided in to two groups. Group-A comprising 55 patients with AFI >5 cm and Group-B comprising 55 Patients with AFI less than 5 cm or equal to 5 cm. Results: In our study, Out of 55 oligohydramnios patients, 43.64%(24) were induced, 27.27% (15) were augmented & 29.09%(16) were left for spontaneous progression of labor & out of 55 normal AFI patients 58.18%(32) patients were induced, 29.09%(16) were augmented, 12.73%(7) were left for spontaneous progression of labor. Mean Apgar score at 1 & 5 minute of birth is comparatively low in oligohydramnios patient & nursery admission was more, but only short term neonatal morbidity was seen. No long term consequences were present in these babies. Conclusion: An AFI ≤5 cm detected at term that was at or after 37 completed weeks of gestation in a low risk pregnancy was an indicator of poor perinatal outcome. Oligohydramnios was being detected more frequently now-adays due to ready availability of ultrasonography these days.

Objective: The objective of this study was to analyze the prognostic value of lymph node ratio in patients with gastric cancer. Methods: A total of 22 cases of total and subtotal gastrectomy received in the period of January 2015 to July 2018 in the department of pathology of a tertiary care hospital were assessed. The surgical data and the histopathological findings were assessed using definitive criteria. Pearson’s correlation coefficient and chi-square test was used to study the relation between the lymph nodes showing metastasis and the total number of lymph nodes harvested. The relation of LNR with the other clinicopathological parameters was studied. Results: A cut off value of 0.25 was taken and the cases were grouped into low grade and high grade LNR group. In this study we found that the LNR was associated with the number of metastatic lymph nodes, irrespective of the total number of lymph nodes dissected. Hence it could be used as a prognostic indicator even when less number of lymph nodes is retrieved. Conclusions: LNR could be considered as a valuable prognostic factor and could be used as an additional tool with the TNM staging system to assess prognosis in patients post-surgery. It is especially useful in cases where prescribed number of lymph nodes cannot be retrieved.

Background: Induction of labour is an intervention that artificially initiates uterine contractions leading to progressive dilatation and effacement of cervix and expulsion of fetus prior to spontaneous onset of labour. Methods: This study was carried out in Labour ward at Apollo BGS Hospitals, a tertiary health care centre in Kuvempunagar, Mysore. 50 patients with an indication for induction of labour was receive 0.5 mg intracervical dinoprostonegel and repeated for a maximum of 3 doses every 6 hours as needed. 50 patient with an indication for labour induction was receive with 20ml [20 microgm] oral misoprostol solution and repeated every 2 hourly until adequate uterine contractions occurred [3 contractions per 10 min lasting 30-40 second]. Results: The average number of cerviprime gel doses given per patient was 1.42 ± 0.6417, whereas the average number of oral misoprostol solution doses given per patient was 4.52±1.2162 (p < 0.001). Conclusion: In conclusion, we found that both misoprostol and dinoprostone are useful and safe drugs for cervical ripening and labour induction when used at flexible doses and at intervals of 6 hours between doses in a low-risk population with unfavourable cervices. However, misoprostol offers the advantages of more rapid labour and less cost.