Background: Menopause is an important transitional phase in women's life and needs active coping. Aim of study was to: Describe the coping patterns among menopausal women working at Zagazig University Hospitals. Subjects and methods: Research design: A descriptive study design was used. Setting: The study was conducted in the emergency departments of Zagazig University Hospitals (four hospitals). Sample: A purposive sample composed of 240 menopausal age fulltime employees at the setting. Tools of data collection: Two tools were used, Tool I: A self-administrated questionnaire composed of 3 parts. Part one: Covering respondents demographic. Part 2: This was for the details of women's obstetrical history, menopausal characteristics' and various menopausal symptoms .Part3: Intended to assess woman’ knowledge about menopause. Tool II: Various women coping strategies to deal with menopause. Results: The duration of menopause among the study sample was less than five years in 65.0% with a mean of 3.8 ± 2.7 and 62.1% had moderate/ severe menopausal symptoms, in additions to 79.6% of the study sample had total satisfactory knowledge. The cognitive coping strategy was the most commonly used 74.2% and only 15.4% &12.1% respectively of the study sample were using the re-interpretation and catastrophizing strategies. Conclusion: A high proportion of the menopausal women suffer moderate to severe menopausal symptoms, their knowledge about menopause was high, and they mostly use the cognitive coping strategy. Recommendations: The study recommended educational programs to improve women’ knowledge and coping regarding menopause.

The term "esthetics" is borrowed from the Greek word "aesthesia", which means sensation or sensibility. It can be defined as "belonging to the appreciation of the beautiful". The relation of this term to dentistry has been differentiated from the word "cosmetic", which is derived from the Greek word "kosmos", or adornment. It is further stated that esthetic dentistry enhances the natural beauty of the mouth and face and that the term is used specifically to imply an improved relationship rather than a superficial one. This article reviews about principles for anterior dentition esthetic treatments

As the growth of international marriages increased, this thematic analysis study focused on mothers-in-law in multicultural families in South Korea. This study explored mothers-in-law‟s experiences of living with an immigrant daughter-in-law in multicultural families in South Korea. This study used thematic analysis of qualitative methods, included 10 mothers-in-law selected from rural areas. The participants‟ attitudes toward the marriage of their son were divided into three stages; “the early stage,” “acceptance of the international marriage,” and “life at present.” These three stages comprised 5 themes and 14 sub-items. Mothers-in-law living with an immigrant daughter-in-law had many physical illnesses, psychological problems, and they felt guilty or that they had sinned. However, they had no support system. Participants of this study wanted to receive social support and sincere human relationship. In practice, the Korean society needs to change its perception and develop positive attitudes toward multicultural marriages.

Introduction: Incidence of shivering after spinal anaesthesia is common complaint in present anaesthesia practice. Several drugs available to manage shivering such as Pethidine, Tramadol, Dexmedetomidine etc. Among all Dexmedetomidine is effective. This study was designed to assess the efficacy of Dexmedetomidine, Tramadol and Pethidine in the management of shivering under spinal anaesthesia. Materials and Methods: A total 120 cases between age group 21 to 60 years, undergoing elective lower abdominal and lower limb surgeries under spinal anaesthesia method between ASA grade I&II were recruited. Based on drug administered study cases were randomly divided into 3 groups Group 1 with Inj. Tramadol 0.5mg/kg, Group 2 with Inj. Pethidine 0.5mg/kg and Group 3 with Inj. Dexmedetomidine 0.5μg/kg. Heart rate, BP, temperature, Shivering grades and seduction grades was noted for every 5 minutes interval till 15 min and then 15 min interval till 120 minutes. Results: Dexmedetomidine drug was showed better outcome than other drugs. Among the 40 cases, three cases who were given dexmedetomidine had shivering. In tramadol and Pethidine drug groups, 22 and 9 cases had shivering respectively at various time intervals. Dexmedetomidine had onset of sedation at 5 minutes with sedation score 3. In tramadol group, onset of sedation was seen at 15 minutes with sedation score 2. In Dexmedetomidine group, 5 cases had bradycardia and 3 cases had hypotension which was statistically not significant. None of the cases with above symptoms was found in tramadol and Pethidine group. Conclusion: Dexmedetomidine 0.5 μg/kg has been shown effective in reducing shivering than tramadol 0.5 mg/kg and Pethidine 0.5 mg/kg. Dexmedetomidine had higher degree of sedation rate than tramadol and Pethidine

The aim of this study is to investigates the role of auditor Independence and materiality and risk on audit quality reduction, which is mediated by non audit service. In order to generate the goal of the study, we conduct a survey study at the public accounting firm. We test our 246 usable data from public accountant using Structural Equation Modelling analysis. The results indicate that eirther auditor ethics or materiality and risk had a negative effect on reduced audit quality Replacing and altering of audit process. Otherwise non audit services mediate the relationship between auditor auditor independence and materiality and risk to audit quality reduction.

We report the case of an infective Candida albicans fungal endocarditis occurring in a 68-year-old male patient operated on for valvulopathy and with a pacemaker, with a delay of 06 years between his cardiovascular surgery and the onset of endocarditis. The diagnosis was confirmed by blood culture and echocardiography showing the presence of vegetations, the patient was then put under fluconazole with clinical and transient biological improvement before the worsening of the clinical picture and control echocardiography increase the size of his abscess of the mitral ring, which motivated the decision of a surgical treatment.

During the past few decades’ endodontic treatment has benefited from the development of new techniques and equipment, which have improved outcome and predictability. Important attributes such as the operating microscope and ultrasonics (US) have found indispensable applications in a number of dental procedures. Ultrasonics in endodontics has enhanced the quality of treatment and represents an important adjunct in the treatment of difficult cases. Since its introduction, Ultrasonics has become increasingly more useful in applications such as gaining access to canal openings, cleaning and shaping, obturation of root canals, removal of intra canal materials and obstructions, and endodontic surgery. Currently, although ultrasonics (US) is used in dentistry for therapeutic and diagnostic applications as well as for cleaning of instruments before sterilization, its main use is for scaling and root planing of teeth and in root canal therapy, both for orthograde and retrograde therapy. This review article brushes up the role of ultrasonics in endodontotlogy.

Background: Lack of medication adherence to anti-diabetic therapy causes suboptimal glycemic control and leads to treatment failure and increased mortality from diabetes complications. The study aimed to assess medication adherence among type 2 diabetes mellitus patients at outpatient setting and its correlation with glycemic control. Methods: A cross-sectional observational study was conducted between January 2019 and March 2019 at several outpatient clinics in Ibb city, Yemen. A total of 370 patients of type 2 diabetes mellitus who use oral hypoglycemic drug therapy for at least 3 months were enrolled in the study. Fasting and postprandial blood glucose as well as glycosylated hemoglobin were measured and details of drug therapy were noted. Morisky Medication Adherence Scale was used to assess medication adherence. Results: Only 1.1% of type 2 diabetes mellitus patients had high medication adherence to oral hypoglycemic drugs, while 61.9% had moderate and 37% had low medication adherence. Most common medication adherence issues identified in type 2 diabetes mellitus patients were forgetting to take their medication when traveling, stopping of medication once feeling better, and difficulty to adhere to medication plan. Only 12.1% were having optimally controlled glycemic levels, whereas 87.8% were having uncontrolled glycemic levels. Conclusions: Despite having a good overall medication adherence among type 2 diabetes mellitus patients, the glycemic control still low in most patients. The study shows urgent need for reviewing anti-diabetic pharmacotherapy, counseling, and health education of patients.

Generally, many large tissue defects occur with surgery treatments of tumors in the maxillofacial region. Maxillofacial prosthesis application can be used as an alternative treatment for cases where plastic surgery reconstructions cannot be applied. While the retention of maxillofacial prostheses used to be provided generally via adhesive bands, adhesives in liquid or spray form, and tissue undercuts, the current treatment of an intra-oral edentulous condition is frequently conducted via osseo-integrated implants. The most significant problem facing the reinforcement of the facial implants is inadequate bone thickness. While the most suitable reinforcement points for implant are the temporal region and supraorbital edge, the bone thickness varies between 2.5 and 6mm for those regions. This article reviews the application of implants in different maxillofacial prostheses.

The breast is the most frequent site of cancer among women in both developed and in developing countries [1]. Breast cancer is the most frequent cause of cancer death in women from less developed countries and second most frequent (after lung cancer) among women in developed countries [1]. It is increasing in incidence in the developing world due to increased life expectancy, increased urbanization and the adoption of western lifestyles [2]. According to the World Health Organization (WHO), “Early detection in order to improve breast cancer outcome and survival remains the cornerstone of breast cancer control” [2]. Breast cancer staging also takes into account cancer's grade; the presence of tumor markers, such as receptors for estrogen, progesterone and HER2; and proliferation factors.Standard screening for new and recurrent breast cancer involves clinical breast exam and breast imaging. Given the recognized differences in breast cancer incidence, subtypes, and prognosis among women , it is important to evaluate potential biomarkers in the landscape of breast cancer subtypes ranging from DCIS to triple-negative breast cancer (TNBC) to determine if a simple blood test can enhance the diagnosis of this disease and knowing about stage of disease, and helping in proper treatment. In this review we tried to discuss role of genetic panels in breast cancer management

This research was conducted to examine the effect of Good Corporate Governancen (GCG) and debt policy on dividend policy with profitability as an intervening variable. The proxy of GCG in this study is institutional ownership and the frequency of board meetings while the debt policy is proxied through leverage (debt equity ratio). The population in this study is that all companies indexed by compass 100 listed on the Indonesia Stock Exchange in 2016-2017 are 66 companies, with the sampling method using purposive sampling. The results obtained in this study are that institutional ownership has no influence on dividend policy either directly or indirectly through variable intervening ROE. While the frequency of board of directors meetings and debt policy (DER) has an influence on dividend policy both directly and indirectly through variable intervening ROE. The conclusion of the study is that profitability is able to become a variable intervening between GCG proxied through the frequency of board of directors meetings and debt policies that are proxied through DER on dividend policy. Companies that have large profitability tend to provide high dividends.

Public waste disposal workers in Cross River State do not take precautionary measures and are exposed to waste that generates gases, dust and microorganisms. Spirometry and respiratory symptoms in public waste workers in Cross River state, Nigeria was studied with the aid of a spirometer and questionnaire respectively. Dust and gases (NO2, SO2, H2S and FL) emitted from the vicinity were also studied. Two hundred and forty (240) male subjects were used for the study comprising 120 test and 120 control subjects with similar anthropometric parameters. Results showed that the mean FVC (Liters) in the test subjects was significantly reduced (p<0.01) compared to the control. Mean FEV1 (liter) of the test group was significantly lower (p<0.001) than control. Result for FEV1% (Liters) and PEFR (L/min) in the test subjects was not significantly different compared to control. Percentage of oxygen saturation (SPO2%) in both control and test subjects were not significantly different. Dust levels (mg/m3) in the test sites was significantly higher (p<0.001) than in control sites. SO2, NO2 and H2S were significantly higher in test sites compared to control (p<0.05-p<0.01). There was a higher incidence of respiratory symptoms such as productive cough, sneezing etc in public waste workers. Public waste workers had a restrictive pattern of impairment caused likely by significantly high dust levels with SO2 level which exceeded the ambient levels as documented by the Federal Ministry of Environment in Nigeria

Background: Dentists are often faced with a large fluctuation in patient’s inflow to the clinic due to seasonality. This unpredictability of seasonal variation has high impact on revenue. High seasons bring in significantly more revenue than low seasons; dentists may find that certain months have few new patients and more empty chairs. There has been no study documented to find seasonal variation in patient’s inflow to dental clinic. Purpose of this study was to crack the code of relationship between seasonal variation and patients visit to clinic. Materials and method: cross-sectional study was performed for a period of one year in five major cities. Selection of dental clinic was done by probability sampling and one clinic was from all five cities were selected. Result: Study shows monsoon in India is not fruitful for dental practitioners as it attracts fewer numbers of patients to the clinic following summer season. Conclusion: Dental practices can encounter difficulties keeping the doors open if they do not learn to manage changes in seasonality. Study revealed that there was an obvious decline in no patients flow in months of July to September.

Occipital Aneurysmal bone cyst is a rare benign tumor-like mass of the children and young adults. It is more frequent to the long bones and to the spine, but its location to the cranium is unusual. It is a lytic lesion, causing bone augmentation with a heterogeneous bloody content. Since its first description in 1942, only few cases have then been published in the literature and all have been listed in the text. We discuss through a successfully managed case of a 2 years old child the pathogenicity, the morphologic and radiologic criteria suggestive of this unusual pseudo-tumor and also discuss treatment options.

Background: College students may experience severe sleep problems that negatively impact their health and well-being at certain times. The Partial sleep loss may increase the risk of obesity and weight gain. Aim: To assess the association between sleep quality and BMI in medical college students and to determine whether the students with poor sleep quality are at risk of developing obesity. Materials and Methods: 100 medical college undergraduate students of both the sexes aged between 18 - 25 years of Santhiram Medical College, Nandyal was included in the present study. Sleep quality was assessed by Pittsburg sleep quality index (PSQI) questionnaire. PQSI is a questionnaire based study, which is a standardized, quantitative measure of sleep quality with demonstrated high levels of consistency, reliability & validity. Body mass index (BMI) was calculated as weight (in Kg) divided by height-squared (in m2). The relationship between Body Mass Index (BMI) and sleep quality was analyzed in the present study. Results: Among 100 medical college students; 9 students were underweight, 45 were normal weight, 31 were overweight, and 15 were obese in the present study. The mean PSQI in underweight students was 3.1, normal weight was 3.4, and overweight was 2.67 and obese was 4.9.The mean BMI in students with PSQI<5 was23.04±3.89 and in those with PSQI >5 were 23.80±4.40. Conclusion: There was no association between sleep quality and BMI in the present study. We will extend our study in large sample size and by a different methodology with equal number of participants in each BMI category to determine better outcome in the present study.