A left ventricular aneurysm (LVA) is a localized dyskinetic area of infarcted myocardium that bulges in systole and diastole. It is a well studied structural complication seen post myocardial infarction although decreasing in incidence due to major improvements in reperfusion therapy. Persistent ST elevation is the most widely reported electrocardiographic manifestation of left ventricular aneurysms. LVA may be evident on chest x-ray, as observed in this case. Diagnosis is non invasively confirmed using echocardiography. Complications of LVA include congestive heart failure, ventricular arrhythmias and rupture that can lead to sudden cardiac death. Surgical treatment is usually effective and followed by a marked improvement in function but is burdened with a heavy post operative mortality. We report the case of a 55-year-old man, with a history of myocardial infarction presenting with a large left ventricular aneurysm.

Introduction: Pemphigus vulgaris is an rare Autoimmune blistering disease. The common cause of death in Pemphigus is septicemia which is secondary to cutaneous bacterial infection. Aim: The aim of this study is to find out bacteriological profile and its antimicrobial susceptibility pattern in patients with Pemphigus vulgaris attending tertiary care hospital, Jamnagar. Materials and Methods: The present study was conducted using the 198 skin swab culture and sensitivity reports collected retrospectively in department of Microbiology Shri M.P.Shah Medical College, Jamnagar from July - 2018 to July – 2019. Results: During the study 198 culture Reports were analysed. Out of this 91(45%) were culture Positive. Staphylococcus aureus (65.93%) was the most common organism isolated Followed by the Pseudomonas aeruginosa (17.58%), Klebsiella (8.79%). Other isolates include species of CONS, Escherichia coli, Enterobacter and Acinetobacter (7.69%). Out of this High sensitivity rate were observed against linezolid in gram positive cocci and against Imipenem and Piperacilin/ tazobactum in gram Negative bacilli. Conclusion: Secondary Cuteneous bacterial infection in pemphigus vulgaris is fatal. The Most common Organism is Staphylococcus aureus followed by Pseudomonas aeruginosa, Klebsiella and species of E.coli, acenatobacter and enterobacter showing high resistant to routine antibiotics.

Aim: The aim of this study is to compare the Solubility of Endosequence root repair material fast set putty and Mineral Trioxide Aggregate Angelus (MTA-Angelus). Methods and Material: Solubility was determined by preparing stainless steel ring molds which were filled with cements corresponding to two groups (n = 5). Samples were transferred to bottles containing 10 ml of distilled water and stored at 37°C for 1, 7, and 21 days. Solubility was measured as the difference between the initial weight and the weight at the end of each storage period. Results were analyzed using Mann Whitney U test and Wilcoxon signed rank sum test. Results: The results showed weight loss with time for both materials. The solubility of ERRM and MTA on 21 days was more compared to its solubility after 1 and 7 days. Conclusions: There was no significant difference in solubility between endosequence root repair material and mineral trioxide aggregate.

How to respond to pleural thickening on a chest X-ray or CT? Benign pathology or potentially serious subclinical cancer? The differential diagnosis is wide. Only the pathological examination can decide.

Introduction: Most common mode of communication between medical professionals is by visits, telephone and mobile phone calls, meetings of doctors, and WhatsApp usage. WhatsApp has group communication and makes sending of images and videos on same group its usage most effective. Material and Methods: We did a 3 months prospective study in our Surgical Gastroenterology unit (of 15 professionals) using English and Hindi language and compared WhatsApp communication with communication by by telephone mobile phone. Results: Of the total 3462messages delivered 3219 (92.7%) were of patient care only. There were 71 (2.05%) messages related to administrative details, 5.4%(188) messages relates to teaching and academic. Multimedia messages were 145 (4.2%). Time taken to reply a message in routine working hours was found to be of 8 seconds to 25 minutes. Messages done by land line or mobile phone call systems were 184 and the time spend on each was approx 2 to 17 minutes. It was a common opinion of all members was that it’s a very useful tool, it saved time compared to the traditional methods of calling and replying. Conclusion: WhatsApp is a free of cost, easily available and a very reliable mode of use for medical practitioners. It is a development over the traditional telephone or call on mobile phone.

Hydatid disease (HD) is a zoonotic infection caused by larval stage of Echinococcus granulosus. It is a worldwide health problem causing significant socio-economic impact. This retrospective study included 19 patients diagnosed with HD at a university medical center between 2007 and 2019 in Western Region of Saudi Arabia. There were 68% (n=13) males and 32% (n=6) females (mean age 40 ± 17 years). The clinical presentations were variable and non-specific. The affected organs were as follows: liver (68%), lung (32%), soft tissue (11%), peritoneal nodule (5%), kidney (5%), and brain (5%). Multiple organ involvement and combined liver and lung were seen in 26% (n=5) and 16% (n=3) of the patients, respectively. The mean diameter of cyst was 8.98 ± 1.77 cm. Serology confirmatory test was positive in 95% (n=18) of the patients. Blood eosinophilia was noticed in 32% (n=6) of the patients. Histopathological and cytological features include laminated cyst wall, inner germinal layer and protoscolices. Management included cyst resection or PAIR (Puncture, Aspiration, Injection of protoscolicidal agent and Re-aspiration) technique combined with anthelmintic drugs. The overall recurrence rate was 7.5% and 60% for surgery and PAIR, respectively. Overall mortality rate was 0%. In conclusion, considering that there is no pathognomonic clinical feature for HD, it may lead to confusion and delaying in diagnosis. Good history including exposure to dogs in the endemic areas, good imaging modalities and the proper use of serology might help for suspecting HD. The histopathological findings are valuable in confirming diagnosis of HD.

Background: Numerous restorations have been used in dentistry to substitute the lost natural tooth structure. In attempts to improve the mechanical properties of glass ionomer, a nano-zirconia reinforced glass ionomer was introduced. The aim of the study was to compare the impact of cyclic stresses on flexural strength of two aesthetics restorative materials. Materials and methods: A nano-hybrid composite resin and a nano-zirconia reinforced glass ionomer were used in this study. A total of 80 specimens, 40 for each restorative were fabricated. In each group, 10 specimens were assigned for each aging condition as following; control, thermo-cyclic stresses, mechanical-cyclic stresses and combined thermo-mechanical cyclic stresses. Then the specimens were submitted to 3-point loading test using the Universal Testing Machine. Results: In all test conditions, nano-hybrid composite resin showed statistically significant higher mean flexural strength than nano-zirconia reinforced glass ionomer (61.1MPa SD ±17.3, 24.2 MPa SD ± 9.9 P-value <0.001). The control condition showed the highest statistically significant mean flexural strength (59.4 MPa SD± 26.8, P-value<0.001), while the combined condition showed the lowest statistically significant mean of flexural strength (29.7 MPa, SD±15.9, P-value <0.001). Conclusions: Nano-hybrid composite showed superior performance than zirconia reinforced glass ionomer when subjected to cyclic stresses; either thermal, mechanical or combined.

Mycoplasma pneumoniae has been well established as a major cause of lower respiratory tract infections (LRTIs) accounting for 10-30% of all cases of community‑acquired pneumonia and is clinically indistinguishable from other infectious causes of pneumonia. The study aimed to investigate the occurrence of M. pneumoniae as the etiologic pathogen in LRTIs among children and to compare Polymerase Chain Reaction [PCR] and serology for the diagnosis of M. pneumoniae in community-acquired LRTIs in children. A total of 133 children aged between 6 months and 12 years with signs and symptoms of community-acquired LRTIs attending the Paediatrics OPD, emergency or admitted to the wards of a tertiary care hospital were prospectively enrolled into the study. M. pneumoniae in throat swab samples was detected by conventional PCR, and compared with serology and clinical signs and symptoms. Univariate analyses was conducted to determine the association of M. pneumoniae infection among different categories of patients. 31 out of 133 patients included in the study (23.3%) were positive for M. pneumoniae by any test. Among 31 patients, serology (IgM) was positive in 19 patients (61.2%) and PCR in 12 patients (38.7%); 2 patients were found to be positive by both methods. Fever, cough, hurried breathing and intercostal retraction were the clinical signs and symptoms significantly associated with LRTIs due to M. pneumoniae (P<0.05). A combination of clinical features, PCR and IgM for Mycoplasma pneumoniae is recommended depending upon the duration of illness for optimal diagnosis, timely initiation of therapy and to prevent overuse of macrolides.

Diabetes, is a metabolic disease, and is one of the most common endocrine disorders affecting almost 6% of the world’s population. This study intends to determine the prevalence of obesity and risk factors among type 2 diabetic patients, with the aimed of providing some possible measures to the finding in order to improve the level of health care rendered to the patients. This was a hospital-based retrospective study carried out at metabolic clinic of Department of Chemical-Pathology of Usman Danfodiyo University Teaching Hospital, Sokoto Nigeria, from 1st January 2018 to 31st December, 2018. Patients with clinical features of type 2 Diabetes, who were on follow up, were recruited. Data were extracted from the chemical pathology register, other clinical parameters extracted from the patients case folder, entry and validation was done using Microsoft excel version 13. The data were exported it into SPSS version 23.0 (Chicago IL) for windows; for statistical analysis. Numerical data were summarized using measures of central tendency with their respective measures of dispersions. Frequency and percentages were used to summarize categorical data. There where a total of 182 type 2 diabetes mellitus patients confirmed during the study period, the mean age of patients was 53.2, with SD± 16.9, and the age range of (21-87 years) respectively, the peak age incidence occurred within 60-69 decade of life which accounted for 27.5%. More than two-third of patients (n=116, 63.7%) were females. While (n=66, 36.3%) were males. More than half of the study participants (n= 148, 81.3%) were overweight or obese at diagnosis of type 2 diabetes. The study showed that BMI is strongly associated with risk of being diagnosed with overweight or obese, high prevalence of overweight or obesity was observed in female patients as compared to their males counterparts70.3%. Therefore, education on the complications of obesity and DM is very important to the diabetic patients.

Ovarian carcinomas represent sixth most common female cancers and fourth leading cause of death due to cancers in women. Surface epithelial tumors are commonest variety of ovarian tumors followed by germ cell tumors. Angiogenesis is critical factor in tumor growth and metastasis, because tumor proliferation is severely limited by nutrient supply to proliferating tumor cells. Hence tumorigenesis of malignant neoplasms is associated with extensive neovascularization. Many studies has established micro vessel density as an important prognostic factor in solid tumors, but there is paucity of literature regarding characteristics of tumor blood vessels in ovarian surface epithelial tumors Aims and objectives: To clarify the differences in angiogenesis between benign and malignant epithelial tumors. To assess the characteristics of tumor vessels with aid of immunohistochemistry. Material and methods: The study was done on 30 specimens received at Gandhi hospital during May 2017-July 2018. All oophorectomy specimens received at department of pathology after considering the exclusion criteria were included in the study. Routine investigations, ultrasound abdomen and pelvis, H and E staining, immunohistochemistry Smooth Muscle Actin was performed. Smooth Muscle Actin expression is classified as high, moderate, low with normal ovary as control. Results: Out of 30 cases, 15 are benign (50%), 3 borderline (10%) and 12 cases are malignant (40%).Youngest age at diagnosis was 29 years and oldest was at 65 years. Majority of the cases were diagnosed as serous tumors. Conclusion: Smooth muscle actin is highly expressed in benign cases, moderate in borderline and low in malignant cases. Malignant ovarian tumours statistically showed higher production of immature blood vessels along with paucity of smooth muscle support as compared to benign tumours. Therefore Mean MVD is higher and Smooth muscle actin expression is low in malignant tumors.

Introduction: Candida biofilms adversely impact the health of the patients with increasing frequency and severity of disease and with soaring economic sequel. Objective: Qualitative detection of biofilm production and its quantification was performed in Candida isolates from patients infected with health care associated infection (HCAI). Method: A total of 55 Candida isolates were included in the study. Biofilm production was estimated by Tube method (TM) and Tissue culture plate method (TCP). Further quantification of the biofilm produced was performed by XTT (2, 3-bis (2-methoxy-4-nitro-5-sulfophenyl)-5-[(phenylamino) carbonyl]-2H-tetrazolium hydroxide) reduction Assay and Dry weight measurement method. Result: All Candida isolates were found to be biofilm producers by all three (TM, TCP and XTT) methods. Quantity of biofilm produced by C. albicans ranged between 2.3 to 9.1 mg/disk. Among non-albicans Candida Candida tropicalis) it was between 2.2 to 7.3 mg/disk whereas non-albicans Candida (except C. tropicalis) weight of the biofilm was 2.0 to 7.1 mg/disk. Conclusion: Dry weight (DW) is the actual quantity of biofilm produced. Candida albicans produced higher quantity of biofilm than non-albicans Candida in the study. It is also concluded that quantitative detection of biofilm is definitely help clinician in deciding modality of treatment.

Background: This study was aimed at investigating the Prevalence Pattern of axial triradii in the Ikwerres’ Binis’ and Igbos’. The study was an observational, analytical and cross-sectional design with volunteers age ranging from 18-60 years. For the purpose of this study, an individual was considered to be a Nigeria of a particular ethnic group if the parents and four grandparents are of the same ethnic group. Materials and Methods: Cluster sampling method was used for the study. The selection and collection of required parameters relied on informed consent of volunteer subjects. This was done by giving them a copy of the informed consent letter which was signed and dated. A total of 1,200 subjects (Bini 400, Ikwerre 400 and Igbos 400) subjects were recruited for the study. The fingerprints were obtained using print scanner (Hp G3110 Photo scanner) following Oghenemavwe and Osaat (2015) improvised model. Results and Discussion: Result of the study showed that the total prevalence of the axial triradii across the three ethnic groups (n=1,200). For Ikwerre (n=400), the total prevalence of the triradii were thus for the right: t 210(52.5%), t1 128(32.0%), t2 62(15.5%) while on the left thus t 204(51.0%), t1 126(31.5%) and t2 70(17.5%). For Bini (n=400) were thus on the right: t 192(48.0%), t1 130(30.3%), t2 78(19.5%) while on the left thus t 187(46.8%), t1 131(32.8%) and t2 82(20.4%) and the Igbos (n=400) were thus on the right: t 181(45.3%), t1 115(28.8%), t2 104(25.9%) while on the left thus t 174(43.5%), t1 116(29.0%) and t2 110(27.5%). In the prevalence of the position of axial triradii across the three ethnic groups, the t-position was the most prevalent, followed by t1 and t2. In the Igbo population there was an increased prevalence of t2 on the left hand compared to the Ikwerre and Bini population. Conclusion: The similarity in prevalence pattern of the axial trradii suggests possible genetic proximity and that the Ikwerre people may possibly have received con

The study investigated the effects of Station Rotation Model (SRM) in public secondary school students’ performance in reading comprehension in Delta State, using a quasi- experimental design of the pretest, protest and control type. A sample of 50 students were randomly selected using a purposive sampling technique on a population of 1480 students of SSS II in three schools in three Local Government Areas of Delta State. The instrument to elicit students’ Performance is Reading Comprehension Performance Test (RCPT) pretest and posttest with reliability coefficients of 0.78 and 0.84 respectively. Three research questions were formulated to guide the study while three hypotheses were stated and tested at 0.05 significance level. Data collected were analyzed using the descriptive statistics of mean and percentage to answer research questions while inferential statistics of analysis of covariance (ANCOVA) was used to test hypotheses. Results show that at 0.05 significance level and df (2, 99) there is no significant difference between students mean performance taught Reading comprehension using the Station Rotation Model and those taught using the Lecture Method. There is no significant difference between the mean performance scores of the male and female students taught reading comprehension using the Station Rotation Model (SRM) form of blended learning strategy. However, descriptive analysis show that the mean difference performance scores of the female students is greater than those of their male counterparts (6.52 > 5.44). Keywords: Station Rotation

Since the Rio declaration which held in Brazil in 1992 on the Environment, the draftsmen of the law have often taken recourse to principles when regulating new areas of the law, one of which includes the polluter pays principle. Cameroon has domesticated this principle in its 1996 Environmental management law which is one of the most important principles of international environmental law. The fine imposed on polluters in Cameroon is paltry and therefore cannot really achieve one of the most desired objectives of punishment which is deterrence .The purpose of this paper is to investigate the nature of the liability of the polluter and the quantum of damages imposed on the polluter when he pollutes the environment. The paper is also aimed at investigating whether the principle is an appropriate tool for the liability of polluters under Cameroonian environmental law. In other words the aim is to investigate why the fine levied on polluters is derisory and whether the principle is an effective tool in the compensation of victims of environmental pollution. The paper does so through a reading of records mainly from documentary and Internet search. The data thus collected constitutes the sources from which the law is drawn, stated and analysed in the light of the stated aim of the paper. The results inter alia identify that the polluter pays principle is suppose to be an effective tool in the compensation of victims of environmental pollution but for it to be effective, it must comply to other international law principles such as that of equality, non-discrimination and most importantly the quantum of the damages imposed on the defaulter should be severe enough so as to deter not only the violator from committing the criminal act in future but also to prevent others from following suit. The said results also highlight the limitations and advantages of the polluter pay principle. The results are significant as they expose gaps in the current law in relation to the poll

In 1988, the National Constituent Assembly promulgated the Brazilian Constitution, creating the Provisional Measure (MP) through Art. 62, which is a single act of the President of the Republic, due to urgency and relevance of the subject, with an immediate force of law, for a period not superior to 60 days. In this article, N=1,512 MPs, issued from 1988 to 2019, were analyzed. Key findings pointed out 1,160 MPs converted into Laws (77 percent conversion tax), 67 MPs in process, from which N=51 MPs are still in force for 18 years. This inconsistency is given by the Constitutional Amendment 32, issued on September 11, 2001, which altered the termination clause over time from Art. 62, paragraph 1st, under investigation. The implications are potential legal uncertainty arising from disparities, regarding provisional measures that became permanent, until appreciated by the Brazilian Congress. Case analysis and discussion complete the present work.