This study analyzes the influence of profitability, leverage and CEO narcissism on tax avoidance in manufacturing companies listed on the Indonesia Stock Exchange in 2013-2017. This study uses secondary data, which is obtained from the company's annual report through the official website of the Indonesia Stock Exchange, www.idx.co.id and www.sahamok.com. The companies taken in this study were 41 out of 145 companies conducted by purposive sampling and the number of observations made during 2013-2017 so that the number of observations was 205 samples. Data were analyzed using analysis with SPSS 25. The study stated that profitability, leverage and CEO narcissism variables had a positive and significant effect on tax avoidance.

As the National Book Award winner of America in 2013, The Good Lord Bird plays an important role in depicting the inner world of ordinary people, especially slaves. The young slave narrator, Henry Shackleford recreates John Brown's raids on Harpers Ferry on the eve of the American Civil War. His role changes and choices in his life reflect the identical dilemma and awakening of the black slaves in that era. Based on Ethical Literary Criticism, this paper displays Henry’s identical dilemma in The Good Lord Bird from two aspects of gender dilemma and social dilemma. It explores reasons for Henry’s dual identical dilemmas and the ethical choices, which is to be a girl in bondage or a boy in freedom. Therefore, this paper reveals the inefficiency and blindness of the black slave's ethical choices in the context of slavery, representing the loneliness and alienation faced by the black slaves on the eve of American Civil War. It awakens people to recognize the hypocrisy and evilness of Slavery, and makes human beings re-examine history, giving important enlightenment to American racial issues.

Summary: Mental health protection is a special area of interest for lawyers, ethicists and doctors. He directly refers to such special topics as: compulsory treatment of the patient, use of direct coercion towards the sick person and incapacitation. Psychiatry is inevitably combined in its activities with the law. When undertaking forced actions, it is necessary to analyze the patient's situation. This analysis applies not only to the health sphere. It also refers to the assessment of the level of respect for human rights. The law on mental health protection has been in force in Poland for 25 years. The indicated act was changed several times. These activities were aimed at increasing the level of protection of human rights. Over the past months, unanswered questions and challenges have emerged. They concern the situation of people leaving prison. In the last months, it turned out that the Polish system of mental health protection does not take into account the situation of former prisoners. Is it possible to force a given person to heal? How to deal with a situation in which a person leaving a prison does not want to be treated psychiatrically? What to do if the person is in danger? The presented article aims to show important gaps in the Polish system of forensic psychiatry. A new draft of changes to Polish law will also be shown. It concerns the situation of people leaving prison: those who have been diagnosed with mental disorders. It will be subjected to a preliminary analysis.

Background: Infectious diseases are the leading cause of death world-wide despite the vigorous campaigns that have been made to combat them. This has been occasioned by drastic growth of drug resistant pathogens. Plant based antimicrobials represent a vast untapped source of medicines and a further exploration of plant antimicrobials is called for. Plant extracts have led to the discovery of many clinically useful drugs such as emetine, berberines and quinine. There is a continuous and urgent need to discover new antimicrobial compounds with diverse chemical structures and novel mechanisms of action for new and re-emerging infectious diseases. Therefore, researchers are increasingly turning their attention to exploring untapped opportunities of natural products, looking for new leads to develop better drugs against microbial infections and other diseases. The objective of the study is to determine In-vitro antibacterial activity of different extracts and fractions of Lophira lanceolata plant. In this study, the plant extracts were screened for their antibacterial activity against selected strains of bacteria, including Gram-negative (Escherichia coli and Pseudomonas aeruginosa) and Gram-positive (Bacillus subtilis and Staphycoccus aureus). The diameter zone of inhibition was determined using agar well diffusion method. Ethanol extract was found to have the highest activity while aqueous extract has the least against the tested strains. The n-hexane, ethylacetate and residual aqueous fraction have no activity whereas the n-butanol fraction has activity. The MIC of ethanol extract was found to be inhibitorier than methanol and aqueous extracts. The MBC of the extracts revealed that methanol, ethanol and aqueous extracts are bactericidal on one or more organisms while n-butanol fraction is bacteriostatic to all test strains at the concentration used. Conclusion: Conclusively, the stem-bark of Lophira lanceolata possessed in-vitro antibacterial activity with highest active observed in ethanol extract.

Background: Urinary tract infection (UTI) is one of the most widely spread and costly medical complications of pregnancy, occurring in nearly 20% of all pregnancies. Aim: The purpose of this study was to estimate the prevalence of UTI among pregnant women and risk factors in Derna city during 2017 – 2018. Results: A total of 140 pregnant women were recruited in this study. The mean age of pregnant women was 28.24±5.6 ranges from 17 to 49 years old. The prevalence of urine tract infection was 49.3% (69 of 140), 66 (47.1 %) of them had urine tract infection symptoms. More than half of the women were in second trimester (53.6%), 70% were multi-gravid and 55% had previous history of urine tract infection. A total of six bacteria species were isolated and identified, Staphylococcus aureus was more frequently isolated (55.9%), following by E. Coli (17.6). Conclusion: Urine tract infection is commonly encountered in pregnant women, Regular antenatal care including routine urine testing at every visit to detect and treat asymptomatic bacteriuria is recommended. Patients should be taught proper urine sampling techniques of clean catch mid stream urine. Positive samples should be sent for sensitivity and appropriate antibiotic use according to tested sensitivities

Excessive use of chemical fertilizers in agriculture causes degradation of soil and vegetation health. The consistent use of such agrochemical products shows harmful impacts on the environment. Therefore, urgent needs an eco-friendly substance which replace the chemical fertilizers. Thus, in the present study, the main objective was to evaluate the effect of fly ash to improve the growth and the management of root-knot nematode (Meloidogyne incognita) of carrot (Daucus carota L.). A greenhouse experiment was conducted to observe the effect of different levels of fly ash concentrations (10%, 20%, 30%, 40% and 50% w/w) with normal agriculture soil on plant growth, photosynthetic pigments and against to disease intensity of nematode. Plant growth parameters and photosynthetic pigments were increased significantly from 10% to 30% fly ash levels as compared to control (0% fly ash). Maximum growth and photosynthetic pigments were found at 30% level of fly ash. But at higher levels of fly ash (40% and 50%), plant growth was reduced significantly. However, in the experiment of nematode management the number of galls, egg masses and eggs/egg mass gradually suppressed as the levels of fly ash increased from 10% to 50% and promote the growth of plant at 30% concentration of fly ash as compared to untreated inoculated control (0% fly ash with nematode).

The aim of current study was to develop simple and convenient dosage form for delivery of naratriptan hydrochloride. Mouth dissolving tablets of Naratriptan HCl were prepared using superdisintegrants Croscarmellose sodium, sodium starch glycolate, crospovidone, using sublimation methods. Camphor was used as a sublimating agent. The prepared tablets were evaluated for thickness, uniformity of weight, content uniformity, hardness, friability, wetting time, water absorption ratio, in vitro disintegration time and in vitro drug release. The tablet disintegrate in vitro within 12-14 sec. Almost 95% of drug were released from all formulations within 10 min. The formulations containing camphor, crospovidone was found to give the best results. The tablets prepared by this method exhibited higher rate of release

Lymphadenopathy is the most common presentation in the head and neck region and may occur due to inflammatory conditions, as well as primary and secondary neoplasms. An early and accurate diagnosis helps the clinicians in starting the specific therapy on time, thus reducing morbidity and mortality. The present study was undertaken to know the spectrum of lesions found in the Enlarged cervical lymph nodes in 628 patients. Cervical group of lymph nodes are the most common lymph nodes involved in head and neck region. Non-specific reactive lymphadenitis is the most common benign pathology associated with enlarged lymph nodes whereas metastasis is the most common malignant condition. Most common age group of enlarged lymph nodes in benign category was 3rd decade and in malignant category was 6th decade. The sensitivity and specificity of FNAC is fare enough with lot of various other advantages like rapid diagnosis, reliable, less traumatic, minimal complication, repeatability, economical and convenient. Fine needle aspiration cytology in our experience provides a reliable method of investigating lymph node enlargement, the efficacy of which approaches that of other similar diagnostic procedures and in the present study, over all accuracy and sensitivity was 94.8% and100% respectively.

Keywords: Takotsubo syndrome, cardiomyopathy, mitochondrial, statins, acquired.

Moisture sorption isotherms describe the relationship between moisture content and water activity in food. In this study, adsorption and desorption isotherms for baobab fruit pulp powder was investigated. Static gravimetric method for adsorption and desorption over the range of temperature (27-42 oC) and water activity (aw) (0.10-0.80) was used. The experimental data were compared with four recommended models in the literature for food sorption isotherms (GAB, modified Oswin (MOE), modified Henderson (MHDE), and modified Chung-Pfost (MCE). Equilibrium moisture contents decreased with increase in temperature at all the water activity levels studied. The differences between the adsorption and desorption curves were significant at p<0.05 and the hysteresis loops were affected by temperature. GAB model was found to be suitable for predicting the moisture sorption isotherms for baobab fruit pulp powder. Results obtained from this study showed the relationship between temperature and water activity as it affects the shelf life of baobab fruit pulp powder.

Thyroid hormone is very important for optimal functions of the body including the cardiovascular system. Hypothyroidism has significant adverse effects on the functions of the cardiovascular system. Overt and subclinical hypothyroidism is associated with increased risk of cardiovascular-related mortality and morbidity. Methods: This prospective cross-sectional study was done in the Department of General Medicine, Govt. Medical College, Mahaboobnagar. A total was n=47 with n=15 males and n=32 females were included based on inclusion and exclusion criteria. The patients with clinical symptoms of hypothyroidism were diagnosed and confirmed by chemiluminescence immunoassay (CLIA) method for TSH, FT4 and FT3 levels other investigations were CXR, ECG, and 2D echo. Results: Out of total n=47 patients there were n=15 male and n=32 females. The total number of cases with hypothyroidism in the male group were n=15 out of which n=6 showed cardiovascular involvement and n=9 did not show cardiovascular involvement. Bradycardia was found in n=2 male and n=9 females and decreased in heart sounds was found in n=6 male and n=7 females. Echo findings were Diastolic dysfunction was found in n=10 female and mild diastolic dysfunctions were found in n=6 female. One case each of IVS thickness and pericardial effusion was found in n=5 males and n=11 females. Conclusion: Hypothyroid patients can present with different symptoms which may be sometimes non-specific. High suspicion is the key for early diagnosis of hypothyroidism. The appearance of cardiovascular symptoms depends on the duration of hypothyroidism. Treatment with appropriate doses of L-thyroxine depending on the levels of TSH and proper patient compliance to the treatment will generally ensure the reversal of the cardiac abnormalities

Teeth are the most natural, noninvasive source of stem cells which are easy, convenient, and affordable to collect, hold promises in therapeutic applications. Stem cells of the pulp appear to hold the key to various cell-based therapies in regenerative medicine, but most of the possibilities are in experimental stages and many procedures are undergoing standardization and validation.

Considerable body of knowledge has been amassed with respect to the psychological, sociological, medical and economic effects of joblessness on unemployment at both the micro and macro levels. There is no doubt that for the vast majority of people in this modern era, the issue of being confronted with redundancy and its consequent unemployment is a mentally disturbing and an unpleasant experience. The aim of this paper is to relay general considerations, mainly social-psychological in nature that may be relevant to professionals who encounter by virtue of depressed economy individuals adversely affected

Introduction: AIDS is characterized by a number of opportunistic infections which are responsible for high morbidity and mortality. The spectrum and distribution of opportunistic infection (OIs) in AIDS patients is due to viral cytopathology and are secondary to the failure of both cellular and humeral response with CD4 count of <200 mm3 leads to morbidity and mortality. Material and Methods: This is a descriptive and analytical study. Incidence of clinically and laboratory confirmed cases of opportunistic infections in HIV patients are recorded, during the one year period from June 2017- May 2018. Samples of these patients processed for CD4 counts, to assess the immune status. Results: 500 HIV seropositive patients with OI were studied. Out of these 308 (61.6%) patients had bacterial infections, of which TB (56%) was predominant infection with CD4 count <200mm3. 85 (17%) patients had viral infections, of which common was Herpes zoster 72 (14.4%). 65 (13%) patients had fungal infections of which common was oral candidiasis 46 (9.2%) with CD4 count <100 mm3. 42 (8.4%) patients had parasitic infections, of which common was chronic diarrhea 40 (8%) with CD4 count <100mm3. Commonly observed risk group was in heterosexual group (86.8%). Conclusion: Our study helps the programme manager to plan appropriate strategies for the investigation and treatment of common OIs as a part of management programme for HIV infected populations. It helps them for early diagnosis and manage the patients

Body fluids like pleural, ascetic/ peritoneal, synovial and cerebrospinal fluids are usually sterile, but they can get infected by different microbes, thus leading to life threatening infections. This study was aimed to identify the prevalence of common bacterial isolates in effusions; determine the antimicrobial susceptibility pattern; correlate the microbiological and cytological imprints of effusions. This is a cross sectional and prospective study conducted between January and December 2018 in a tertiary care teaching hospital among the samples received for pathological and microbiological investigations. Of the 267 different body fluids samples processed, 127 (47.6%) were found to have inflammatory cells, 98 (36.7%) with non infectious cells and 42 (15.7%) with malignant cells in cytology. Of the 127 inflammatory samples, 42 samples supported with bacterial growth. The most common pathogens isolated were Klebsiella pneumoniae (n=12;28.6%) followed by non fermenting gram negative bacilli, Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus and coagulase negative staphylococci. The gram negative isolates were relatively resistant to cephalosporins and quinolones; whereas gram positive isolates resistant to quinolones and aminoglycosides. Knowledge of the cytological investigations, bacteriological and antimicrobial resistant profile of sterile body fluids is necessary for clinicians for appropriate patient management.