Corticosteroids have proved to be extremely effective in the treatment of acute inflammation and chronic inflammatory diseases. Drug utilization review (DUR) is an on-going, systematic, criteria-based program of medicine evaluations that will help ensure appropriate medicine use. The present study aim was to evaluate the drug utilization of Corticosteroids in the various department of a tertiary care teaching hospital, Khammam. A prospective observational study was conducted to evaluate drug utilization pattern of corticosteroids. Total 249 corticosteroids were prescribed Prednisolone was prescribed in 39.5% prescription followed by hydrocortisone in 27%, budesonide in 19%, methylprednisolone in 15.5%, Dexamethasone in 9.5%, Deltazacort in 7.5%, Prednisone in 4.5% and Fluhydrocortisone in 2% respectively. 34 ADRs were detected in the study due to corticosteroid use, facial puffiness was detected in 12.50%, headache in 14.70%, Hypernatremia in 14.70%, Hyperglycemia in 17.64%, hypertension in 26.47% and osteoporosis in 14.70%. 72.6% of the drugs were prescribed from the NELM list. Clinical pharmacists interact directly with patients in several different ways. Hence, the clinical pharmacist can perform potential role in health care system in assisting physician in altering the number of medications taken, the number of doses taken, improving the patient medication adherence, detect the adverse drug reactions, drug interactions, in patient counselling, improve the health related quality of life and decreasing the health care cost of the patient.

Nelsonia canescens is a small perennial herb widely used in Burkina Faso traditional medicine for the treatment of any diseases. In the present study, the purpose was to investigate the potential cytotoxicity and selectivity of different extracts from N. canescens on human cervical cancer HeLa and SiHa cell lines. MTT assay revealed higher cytotoxic activity of methanol extract in a dose-dependent manner against both HeLa and SiHa cells with respective IC50 values of 21.72 ± 0.08 𝜇g/mL and 25.30 ± 0.44 𝜇g/mL. Methanol extract (ME) showed the best selectivity index value of 7.93 ± 0.03 with HeLa cell line and Ethyl acetate extract (EAE) showed the best selectivity index value of 7.48 ± 0.05 with SiHa. The potential cytotoxicity and selectivity of N. canescens extracts against HeLa and SiHa cells line suggest that this species could be exploited further as a potential lead in cervical cancer treatment.

Language teaching is inseparable from culture teaching. As one of the basic elements of classroom teaching, this paper analyzes the cultural content of the New Standard College English Integrated Course 3 with the quantitative discussion. The results show that this course is still dominated by British and American culture, and the proportion of Chinese culture and other cultures is limited. The results of the analysis provide some references for publishing houses and Chinese English teaching.

This study aims to determine the effect of the effectiveness of internal control, good governance and ethics on budgetary discipline. The object of this study is the Supervisor, Corporate Governance Manager, Budget Manager, Internal Auditor, Head of Internal Auditors in companies in the automotive category and automotive spare parts located in the KIIC Industrial Zone, Karawang, West Java. This research was conducted by sending questionnaires to 89 respondents. Therefore, the data analysis used is PLS SEM. The results showed that the effectiveness of internal control variables had a negative but significant effect on budgetary discipline, good governance and ethics had a positive and significant effect on budgetary discipline.

Introduction: Breast cancer in women, and especially in young women, represents a real public health issue given its frequency and severity. The objective of our study is to specify the epidemiological profile; anatomo-clinical; therapy and prognosis of breast cancer in young women. Methods: Descriptive retrospective study spread over a period of 5 years (2013-2017), collecting all the patients followed for breast cancer aged 40 years or less, within the cancer department of CHU Med VI in Marrakech. Results: The average age was 34.2 years (19-40 years). The average age at puberty was 12 years old (9 and 16 years old). Nulliparity was noted in 22% of the cases. Clinically, the T classification in the cases specified was: T1 (n = 48), T2 (n = 128), T3 (n = 52), T4 (n = 42). Clinical lymph node involvement was found in 44% of the cases. Histologically, infiltrating ductal carcinoma was the most common (n = 283). SBR II grade was the most frequent with a rate of 66%, Thirty Fifty percent of all patients had an over-expression of HER2 , Sixty-three percent had lymph node invasion, including 42% with capsular rupture and 31% of patients were metastatic in appearance. Therapeutically, fifty patients had neo-adjuvant chemotherapy. The surgery was conservative in 66% of the cases. Adjuvant chemotherapy was sequential in 61% of the cases. 180 patients had adjuvant radiation therapy. Of the 96 patients with HER2 over expression, 82 received treatment with trastuzumab. Hormone therapy was prescribed in 156 patients or 49% of cases with expression of hormone receptors. In our series, the median follow-up was 8.1 months. The course was marked by a locoregional relapse in fifty-eight patients, and a metastatic relapse in sixty patients. Conclusion: Since screening in our country does not include young women, it would be interesting to reconsider its indications, especially given the growing frequency of this cancer in young women as well as its poor prognosis.

The purpose of this study was to test the hypotheses of the influence of the head of the Study Program Competence, and Organizational Commitment in Islamic Higher Education in Jambi Province. This research is quantitative research with a survey method. The sampling technique used probability sampling with a sample size of 60 respondences. Path analysis was applied for hypothesis testing with a significance level ɑ=0.05. The results of this study revealed that both partially and simultaneously there were influences: 1). There is a direct influence on the competency of the Head of the study Program (X1) on organizational commitment (X2). Based on the results of the analysis calculation, the value of t obtained (9.14) > t table (1.987), so that H0 is rejected and H1 is accepted. It means that the competency of the head of the study program that developed in the institution had a significant influence on organizational commitment. This study implied that the results obtained from this study provide information that Organizational Commitment can be improved by providing an increase in each variable supporting the organizational commitment under study, it could not be done simply by ignoring the other variables in the path of the variable under study.

Backgroup: Pregnancy is a diabeto-genic condition, which is why pregnancy with diabetes is one of the common medical and endocrinological disorder encountered in obstetrics. Diabetes Mellitus complications during pregnancy has become more common worldwide. About 0-4% of all pregnancies are complicated by diabetes mellitus and 90% of those are GDM. Aim of the study: This study was conducted to find out the maternal and fetal outcome of the pregnancies complicated by pre-gestational and gestational diabetes mellitus. Material & methods: This was a cross-sectional analytical study which was conducted in the Department of Obstetrics and Gynecology Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. In this study, a total of 225 patients were selected using purposive sampling technique. There were three groups of pre-gestational diabetic, gestational diabetic and non-diabetic control, designated as Group A, Group B, Group C accordingly; and each consists of 75 patients. Duration of data collection was one year (July 2016 to June 2017). Information collected from all pregnant women (After 28 weeks of gestation) using a questionnaire made for recoding all relevant parameters under study, after proper counseling and taking written consent of the patient or her legal guardian. Results: History of GDM was significantly more common among patients with pre-GDM (38%) and GDM (18%) compared to controls. History of abortion, IUFD and congenital anomaly were significantly higher among pre-GDM mothers than GDM mothers and controls (p<0.05). History of deliveries with macrosomia and still birth was distributed similarly across the groups (p>0.05). Pre–GDM and GDM patients had significantly higher number of patients with HbA1C >6.5% than controls. Mean FBS and PPBS was significantly higher in pre-GDM & GDM patients than control (p<0.05). APGAR score was <7 in significantly higher number of pre–GDM and GDM babies than controls (p <0.05). Mean Weight of the babies was significantly lower among pre–GDM patients than GDM patients (p <0.05). Among pre–GDM patients and GDM patient’s cases of birth asphyxia, Hypoglycemia, hyperbilirubinemia and congenital anomalies were significantly higher than controls (p< 0.05). Conclusion: Interventions such as preconception care for women with pre-gestational diabetes, screening for early diagnosis, patient education, multidisciplinary approach and good metabolic control maintained throughout the pregnancy is the key to successful fetomaternal outcome.

The purpose of the study was to determine the availability and utilization of vocational and guidance counselling services in technical colleges in Taraba State. The study adopted descriptive research design. The area of the study was Taraba state, located in north-eastern part of Nigeria. The population of the study comprises of 743 final year students in the eight technical colleges in the state. The sample size for the study was 223 which represent 30% of the population. Observation checklist and questionnaire were used as an instrument for data collection. The instrument was validated by five experts, three from the department of guidance and counselling and two from the department of technology and vocational education in Nnamdi Azikiwe University, Awka. The questionnaire was trial tested on 20 teachers at Government Technical College Numan, Adamawa state; Cronbach alpha was used to analyze the data generated from the trial and a reliability coefficient of 0.84 was obtained. Frequency count and percentage and percentage were used to analyze data to answer research question one and two. Mean was used to analyze data to answer research question three. Findings from the study indicated that in Technical colleges in Taraba state, there is only one Vocational guidance and counsellor, nine Para-counsellors, and one support staff; there are 10 vocational guidance and counselling services available; and only four vocational guidance services are utilized. It is recommended that technical college proprietors in the state should hire and post more vocational guidance and counsellors for their respective schools and technical college managers should ensure that more vocational guidance and counselling services are initiated and made available to students.

Euphorbia cyathophora Linn (Euphorbiaceae) is commonly known as Wild poinsettia, fireplant, fire on the mountain, milkweed, widely used for the treatment of constipation, bacterial and inflammatory disease conditions like arthritis and rheumatism. Colourful plants are very dangerous like Daffodil, Lantana, Foxglove and such plants are conserved as a genetic resource and used as food, fibre, fertilizer, fuel and in used in diversely way. Euphorbia cyathophora is one such plant. This review highlights the systematic position, vernacular names, vegetative characters, ecology and distribution, phytochemistry and the economical values of the Euphorbia cyathophora are well discussed.

The aim of the company to register its shares in the stock exchange is to get additional funds from investors so that the business continues to grow. The company's financial performance is a factor that is highly considered by investors, but what if the information is not quality based on the audit results from the auditor? This study aims to determine investor reactions to financial performance information and audit quality. The uniqueness of this research is the 2x2 method between financial performance and quality audit so that this study can produce information about how 1) investor reaction to high financial performance with high audit quality, 2) investor reaction to high financial performance but low audit quality, 3) investor reaction to low financial performance with high audit quality, 4) investor reaction to low financial performance with low audit quality. The results showed that investors only react to high financial performance but low audit quality with negative react, it shows that investors are concerned about audit procedures in assessing the company's financial performance. High company performance but has a low audit quality makes investors pay more attention to the company because the good value is actually considered to be detrimental to investors because of its doubtful quality.

Background: Critical thinking is a key element in the field of education. Where many studies have been published regarding the importance of critical thinking while practicing or studying nursing in hospital settings or academic environment, this project indicates the development of critical thinking in nursing students at all levels of their nursing program. Objective: The purpose of the study is to enhance critical thinking in the nursing students to improve clinical practice and judgment. Methodology: A sample of 20 nursing students participated. A questionnaire tool regarding Knowledge, Attitude and Practice of nursing student to enhance critical thinking was used for pre and post-test evaluation. In implementation phase, participants presented with different critical thinking skill development presentations which were based on clinical scenarios. Results: The result analyzed was 18 out 20 participants strongly agreed that critical thinking development workshop enhanced the skill in patient care. The critical thinking assessment too was further assessed over the time period for their consistency and sustainability on utilizing the critical thinking strategy. Conclusion: The enhancement in critical thinking in nursing students is a necessary development in one’s ability ultimately improving patient care outcomes and quality indicators.

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.

Aim of the study was to find out the role of biochemical markers in diagnosis of alcoholic liver disease and non-alcoholic liver disease and compared these values with healthy subjects of Rajasthan. Total 300 subjects were selected in which 200 were selected as patients group (alcoholic liver disease (ALD) and non-alcoholic liver disease (NALD) group) and 100 were normal healthy subjects. Total 100 alcoholic liver disease patients in which 91 patients were male and 09 patients were female. In non- alcoholic liver disease group 55 males and 45 females are enrolled. Patients were distributed age wise. Serum cholinesterase and serum 5-nucleotidase were estimated by commercially available kit on spectrophotometer. Serum cholinesterase level is 2822.99± 716.51 in ALD patients. In NALD patients, serum cholinesterase level was 4299.95±1014.76 and in control group mean serum cholinesterase level was 6303.99±977.59. P-value was statically highly significant. (P≤ 0.0001), as well as serum 5-nucleotidase level was 25.89± 5.77 and 17.70± 4.43 in ALD and NALD respectively. In control group mean level of serum 5-nucleotidase was 9.851± 3.24. (P≤ 0.0001). We conclude that serum cholinesterase level was decreased in both disease group, whereas serum 5-nucleotidase level is increased in both disease groups. Both parameters are liver specific and specific test for alcohol induced or alcoholic liver disease as well as in non-alcoholic liver disease. Both parameters can be used as a marker of liver disease. it was concluded that serum cholinesterase and 5' -nucleotidase are better diagnostic marker then the conventional liver function test that are raised in other liver disease also.

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.

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.