Early diagnosis of lung cancer plays a pivotal role in reducing death rate due to lung cancer. Bronchial washing, brushing and fine needle aspirations not only compliment tissue biopsies in diagnosis of lung cancer but also comparable. We aim to assess the diagnostic utility of bronchial wash and brush cytology and bronchial biopsy in diagnosing various pulmonary lesions and to compare the bronchial wash and brush cytology with bronchial biopsy in patients with lung cancer. All the patients who underwent fiberoptic bronchoscopy at Alluri Sitarama Raju Academy of Medical Sciences, Eluru during the period of August 2016 to June 2018 for suspected lung lesions on chest radiograph/ CT scan and came to cytology division of pathology department for bronchial wash & brush cytology were included in the study along with biopsy in available cases. Total 60 cases of bronchoscopically visible abnormal lesions underwent bronchial wash and/or brush cytology and/or bronchial biopsy. Of them, only 11.8% of cases of lung malignancy was detected by bronchial wash where as 28.9% of cases of lung malignancies were detected by bronchial brush and 58.8% of cases by bronchial biopsy. We conclude that endobronchial biopsies along with bronchial brush give better cellularity and yield when compared to bronchial wash. The probability of finding the histological subtypes is higher in Endobronchial biopsy when compared with brush and wash samples.

Prevention of diabetes and its associated burden has become a major health issue worldwide. The present study was undertaken to assess the changes in insulin sensitivity and endothelial dysfunction well before the onset of diabetes in population with positive family history for diabetes. The objectives of the study is to estimate the levels of serum Adiponectin, Visfatin, Insulin, HOMA IR and platelet derived microparticles P-selectin levels in offspring of type 2 Diabetes mellitus. The healthy volunteers who are aged between 18- 22 years of either sex, were selected based on their family history of diabetes. The study showed a significant decrease in serum Adiponectin and increase in serum Visfatin, Insulin, HOMA IR & P-selectin levels in the offspring of type 2diabetes. The Adiponectin showed a negative correlation with Visfatin, P selectin, Insulin & HOMA IR. Genetic predisposition for diabetes may influence adipocytokine levels which might play a key role in developing diabetes in near future.

Fomite is an inanimate object or substance that could serve as a vehicle for transmission of infectious organisms amongst individuals. A large number of factors may affect the contamination rate of fomite such as moisture, consistent use and overall cleanliness. Fomites that are found in public places, restaurants, hotels, hospitals and restrooms may include among others handbags, mobile phones, money, door handles or knobs of showers, conveniences, faucets and toilet seats, chairs, lockers, sink and tables. Ladies handbags are multipurpose personal gadgets which may usually habour several kinds of microorganisms such as bacteria. The presence of viable pathogenic bacteria on inanimate entities had been reported by earlier investigators. In this study, a total of one hundred (100) handbags from female undergraduate Microbiology students of Gombe State University (GSU), were investigated for bacterial contaminants and their resistance or otherwise to some commercial antibiotics using standard Microbiology procedures. The results obtained revealed the presence of six (6) different bacterial species, namely Staphylococcus aureus, Escherichia coli, Proteus mirabilis, Pseudomonas aeruginosa, Klebsiella pneumoniae and Bacillus subtilis. The antibiotic sensitivity test showed that all the six (6) bacteria were sensitive to Pefloxacin while five isolates (S. aureus, E. coli, P. mirabilis, K. pneumoniae and Bacillus subtilis) , two isolates (B. subtilis and P. mirabilis) and another two isolates (K. pneumoniae and E. coli) were sensitive to chloramphenicol, amoxicillin and streptomycin, respectively. In conclusion, high level of bacterial contaminants were observed from the studied handbags and found some of the contaminants resistant to the tested antibiotics hence, appropriate use of effective disinfectants is highly encouraged to reduce the magnitude of bacterial contaminants and likelihood of transmitting drug recalcitrant organisms.

PPAR-γ plays a critical role in glucose homeostasis and is a molecular target of insulin sensitizing drugs called thiazolidinediones which are PPAR-γ ligands. PPAR-γ ligands also upregulate expression of adipocyte glycerol kinase, resulting into improved insulin action in target tissue such as liver and muscle. PPAR-γ ligand also shown to augment glucose disposal in peripheral tissues by increasing expressions of the glucose transporter genes, GLUT-1 and GLUT-4. Majority of the Diabetes Mellitus Type 2 (DM type 2) patients (80%) are obese, but all obese persons do not develop DM type 2. Serum adiponectin level should be determined by level of PPAR-γ activity in adipocytes. Therefore it will be of interest to explore the difference in the level of serum PPAR-γ level between obese subjects with DM-2 and without DM-2, as both the insulin sensitizing factor’s adiponectin, and vistafin are synthesized in response to FFA. PPAR-γ complex receptor activity. Estimation of serum PPAR- γ level alongwith FBG was done in 90 cases, of which 30 were normal healthy subjects, 30 obese without diabetes type 2 and 30 obese with diabetes type 2. The qualitative estimation of PPAR-γ in human serum was done by ELISA method using ELISA kit from E lab science Biotechnology Co.Ltd. In our study we found a significant change in the level of PPAR- γ between the obese with DM-2 and control subject and also between obese without DM-2 and control subject but we did not find any significant difference between obese with DM-2 and obese without DM-2. In our present study we found the Increased Levels of PPAR- γ in the Obese without Diabetes Mellitus and Obese with Diabetes Mellitus. The levels were 8.03ng/ml ±11.16 and 8.04ng/ml±10.94 respectively. Finally, we observed that the level of PPAR- γ is increased with both the groups, i.e. obese without DM-2 and obese with DM-2 in comparison to normal subjects.

Fungal infections from the Candida have significant cause of blood stream infection. This is troublesome among those who have been hospitalized with serious underlying diseases or those who are immunocompromised. To know the prevalence and types of Candida species in blood stream infection and their antifungal susceptibility pattern. The study was carried out in the Department of Microbiology, PDU Medical College, Rajkot from September 2015 to August 2016. Total number of samples are 207. Blood culture specimens were collected and processed for, culture on SDA and HCDA, Slide culture, Gram stain, Germ tube. Antifungal susceptibility testing was performed by modified Kirby Bauer method as per the CLSI guidelines. 58 (28.01%) Candida spp. [C. tropicalis (18), C. glabrata(14), C. gullermondii(12), C. parapsilosis(10), C. albicans(4)] were isolated from 207 specimens. Out of these, 203 (98.06%) from NICU/PICU and 4 (1.93%) from Skin ward, predominantly Males (57.97%). The isolates sensitivite to Voriconazole (100%), Fluconazole (98.88%), followed by Ketoconazole (73.03%) and Clotrimazole (68.62%). Maximum resistance observed to Amphotericin B, Nystatin, Miconazole, Itraconazole. Candidemia is major cause of mortality due to lack of antifungal therapy. Blood stream infections by Candida species have shown highest rates of inappropriate therapy among all BSIs. Strategies are needed to rapidly identify cases of candidemia who are already suffering from serious underlying disease and develop rapid diagnostic technology that widely available and cost effective. By knowing Antifungal susceptibility pattern, patients who are at increased risk for developing nosocomial candidemia should be treated early with empiric therapy that reduced unnecessary patient mortality.

Primary leiomyosarcoma of the broad ligament is an extremely rare tumor with very few cases reported in literature. We herein report a case of postmenopausal lady, diagnosed pre-operatively on ultrasound and CT as a degenerated fibroid/ ovarian tumor. Post operatively histopathological diagnosis proved to be a leiomyosarcoma. The patient was treated with adjuvant radiotherapy with a dose schedule of 50 Gy in 25 fractions over 5 weeks. Patient is on monthly follow up since 6 months with no complaints

Background: Endometrial carcinomas accounts for 4-8% of all gynaecological malignancies. Over the past 30 years, many genes which cause cancer have been identified in endometrial carcinoma and hyperplasias. Recently, many studies have shown that the most frequently variable expression gene in endometrial carcinoma is PTEN (Phosphatase and TENsilon homologue) tumor suppressor gene which is mutated in about 30 - 50% of endometrial carcinomas. Identification of inactivated PTEN gene is a very important step in the early diagnosis of endometrial carcinomas and hyperplasias. This study was carried out to evaluate the expression of PTEN in the precursor lesions of endometrial carcinoma in peri-menopausal women with abnormal uterine bleeding. Methods: In this cross sectional study, 3634 samples of endometrial tissue were received in the department during the period of 5 years (Jan 2008 to Dec 2012). Of these formalin fixed and paraffin embedded 100 cases of endometrial hyperplasia from perimenopausal women with abnormal bleeding were retrieved and reviewed. PTEN immunohistochemical staining was done and analyzed. Results: Simple hyperplasia without atypia was the most common precursor lesion in perimenopausal women. PTEN expression was significantly higher in immunoreactivity and intensity in simple hyperplasia without atypia. Complex hyperplasia with atypia showed significantly lower immunoreactivity and intensity of PTEN expression. Conclusion: Our study recommends PTEN expression by immunohistochemistry, in all endometrial hyperplasias in the biopsy specimens which is a simple and cost effective technique when compared to other molecular studies.

This study aims to examine the influence of external and internal factors on the price of the company's coal mining subsector for the period 2015-2017. The independent variable used in this study consisted of exchange rate, coal prices, inflation, DER, and ROE. The research sample consisted of 18 coal mining subsector companies. The method of analysis uses panel regression analysis. The results showed that exchange rate and coal price partially had a significant effect on the coal stock price with a 95% confidence level, ROE partially had a significant effect on the coal stock price with a 90% confidence level, while inflation and DER has no significant effect. to the coal stock price. The exchange rate, coal prices, inflation, DER, and ROE simultantly influence the coal stock price, with a determination coefficient of 10.64%.

Background: Basic Life Support (BLS) / Cardiopulmonary Resuscitation (CPR) are an important part of emergency Medical care. Aims and objective: This study was done among Dental practitioners, to know their knowledge and perceptions about BLS, as they are going to face such situations in future, as Doctors. Materials and Methods: This is a cross-sectional study conducted among Dental Practitioners. The awareness about recent guidelines of American heart association (AHA), BLS, and factors associated which include Profession, gender, previous BLS training and updated with Highlights of 2015 were assessed by using a self-administered structured MCQ questionnaire. Statistical Analysis: The descriptive analysis was run to find the proportions of various parameters. Significant results were considered at 5% level of significance. Results: Our participants were aware of BLS, showed positive knowledge and attitude toward it, with the statistically significant p value.Conclusion: By introducing BLS regularly in the Academic curriculum and by routine hands-on workshops, all the health-care providers should be well versed with the BLS skills for effectively managing the life threatening emergencies. Repeated training would increase their confidence.

Children represent proof of manhood or womanhood in the society. The right of the child to birth registration is a prerequisite obligation any parents owe to the child after birth. Birth registration of a child is a fundamental right recognized under international law as well as domestic legislations in most civilized nations under pain of sanctions for non-compliance. The paper took an eagle eye view on the child rights to birth registration in the Cameroonian legal system. The paper also examines the need for birth registration and the socio-legal implications for non registration of child birth in Cameroon and concludes with some robust recommendations for policy formulation which it effectively implemented, will go a mile stone to guarantee the protection of birth registration of a child in Cameroon.

Fermented milk products such as yoghurts can be produced without the addition of any stabilizers. However, some sedimentation of the milk solids would occur in the products (especially drink-type products) and has to be accepted, especially if the shelf-life of the product is more than one week. Sedimentation can, however, be avoided by the addition of stabilizer(s). Pectin has been established as a stabilizing agent in cultured milk products. However, the pectin used is majorly extracted from apple pomace and citrus peels. With the increase in production of processed fruit products, the amount of fruit wastes generated is increasing enormously. Large amount of these wastes poses the problem of disposal without causing environmental pollution. These wastes can be effectively disposed by manufacturing useful by-products from them and one such product is pectin. The peel of passion fruit, for example, constitutes about half of the fruit mass. Given the background of numerous studies which have been carried out on the extraction and characterization of pectin from tropical fruit sources, it is, therefore, necessary to formulate yoghurt stabilized with pectin from these sources and to evaluate its performance in yoghurt. The study was carried out to evaluate pectin extracts from jackfruit and passion fruit peels and their performance in yoghurt production.

Tympanic membrane perforations are encountered by Otologists in clinical practice. It is the most common cause of hearing loss. We in the present study tried to evaluate the size and location of perforation to the degree of hearing loss and the outcome of treatment of these patients in our hospital. Methods: This prospective observational study was conducted in the Department of ENT, Rajiv Gandhi Institute of Medical Sciences [RIMS], Adilabad. A detailed clinical history including the name, age, sex, address, occupation, presenting complains, past history and physical examination and ENT examinations under microscopy was done to assess the size, site, and shape of perforation including Pure Tone Audiometry. All the patients underwent Myringoplasty through postaural approach using underlay technique taking temporalis fascia as graft material. Results: A total of n= 40 patients were included in the study male patients were n=24(60%) and n=16 (40%) were female patients and the male to female ratio was 6:4 with the predominance of male patients common cause of the injuries was related to RTA 18(45%). The right ear was involved in n=18(45%) of cases left ear was involved in n=21 (52.5%) and bilateral involvement was seen in n=1(2.5%) of cases. n=40 patients underwent myringoplasty in the Grade I perforations the preoperative hearing loss was 29.59 ± 6.65 and in the postoperative, after 12 weeks 17.05 ± 4.4 dB and the audiometric gain was 12.54 dB. In Grade II it was 35.40 ± 5.44 dB and postoperative 12 weeks were 18.51 ± 3.5 dB audiometric gains was 16.89 dB. The Grade III had pre-operative levels 37.95 ± 6.10 dB and the audiometric gain 19.84 dB and similarly in Grade IV 37.95 ± 6.10 dB and the audiometric gain was 25.95 dB. Conclusion: It can be concluded the tympanic membrane perforations are very common in men with the frequency of posterior perforations are greater and the hearing loss does not vary substantially with the location of the perforation. Surgical intervention of perforations is required when they fail to heal spontaneously and the audiometric gain following myringoplasty was more where the size of perforations was large

Natural convection in water inside an enclosure between two concentric cylinders has been investigated experimentally during heating and cooling process. This is made by the flowing of water as heat transfer fluid through the inner tube of the test section. The temperature distribution of water filled in the enclosure is established during heating and cooling process. As the natural convection phenomenon majorly depends on the heat source and orientation of the test section, the effect of mass flow rate and inlet temperature of heat transfer fluid on temperature distribution and heat transfer rate is investigated, first. Afterward, the effect of inclination of the test section on the temperature distribution is also established. The test section is inclined at 45o, 75o and 90o with the horizontal. The results obtained with different angle oriented test section are compared with the horizontal test section. It is found, convection heat transfer is dominant in heating process while in cooling process conduction mode of heat transfer dominated over convection. It is also observed that during the heating process, heat transfer rate is higher for vertical test section as compared with the other inclinations.

This study aims to analyze the implementation of the Financial Services Authority's circular letter number 14 / SEOJK.03 / 2017 concerning the health level of regional government-owned banks through a comparative analysis between Bank DKI Jakarta (“Bank DKI”) and Regional Development Bank Jawa Tengah (“BPD Jawa Tengah”) in 2017, the soundness level of PT BPD Jawa Tengah before implementation (2016) and after implementation (2017) and the soundness level of Bank DKI before implementation (2016) and after implementation (2017). The method used in this study is RGEC (Risk Profile, Good Corporate Governance, Earning, Capital), while the long-term goal is modeling the financial performance strategy of the Regional Development Bank. The results of this study shows that the comparison of the performance of Bank DKI and PT BPD Jawa Tengah in 2017 are not significant difference; the comparison of the performance of PT BPD Jawa Tengah are not significant difference for 2016 and 2017, but the comparison the performance of Bank DKI for 2016 and 2017 are significant difference. The implementation of Circular Letter Number 14 / SEOJK.03 / 2017 regional development banks period 2016 (before) and 2017 (after), shows that the assessment of financial performance of PT BPD Jawa Tengah are not significant difference, however the assessment of financial performance of Bank DKI are significant difference. In 2017 after the implementation of Circular Letter Number 14 / SEOJK.03 / 2017 the results shows that the comparison of the performance of PT BPD Jawa Tengah and Bank DKI are not significant difference.

Blood is a lifesaving resource; it can be infused to a needy patient from a healthy donor after proper screening and cross matching. Infected blood is also a source of transfusion transmissible infections particularly Hepatitis B & C, Human Immunodeficiency Virus, Malaria and syphilis. Stringent screening of each blood unit donated reduces the prevalence rate up to some extent. The objective of this study is to know the seroprevalence of HBsAg among the blood donors in a tertiary care hospital. It is a prospective study done for 3 years between January 2016 and December 2018 with a sample size of 55,376 donors. The overall prevalence among the blood donors in this study was 3.58 % and is more among the replacement donors within the age group 18-40 years. To reduce the prevalence of HBsAg blood transfusion services should be stringent in selecting a donor; proper pre and post donation counseling should be given to the donor. Implementation of more sensitive tests such as NAT for HBV that detects HBV infection earlier during the window period will further decrease the risk of transfusion transmitted HBV and improve the blood safety.