Topic: The advent of gynecological endoscopic surgery at a tertiary care hospital in Sikkim, a remote north- eastern state of India. Gynecological surgeries are being increasingly performed worldwide and have gained popularity because of shorter duration of surgery, decreased blood loss and faster recovery after surgery which decreases the cost of hospitalization. This has generated a keen interest in a large number of gynecologists who are getting trained in laparoscopic procedures and in turn are facilitating the establishment and smooth running of laparoscopy units in their own working area. The laparoscopic unit in our hospital was also started with the idea of imparting quality health care to the patients. The difficulties encountered in setting up the unit, monetary issues , training of surgeons and then counselling the patients about the advantages of undergoing laparoscopic surgery and their dilemma in accepting laparoscopic surgery in place of open surgeries are will be discussed

Achatina fulica snails from two environments (natural and breeding) were subjected to two diets, one based on green fodder and the other in the form of flour concentrate, respectively, in order to assess their impacts on the development of gametes. 50 snails were dissected, with 25 from the natural environment and 25 from the breeding environment. Subsequently, the extraction of gonad (ovotestis) was performed on each of the selected animals. After inclusion, histological sections were made to assess the degree of evolution of gonad according to development scales. This allowed us to identify the different stages of sexual development, sexual maturation per size class according to diets.

Learning achievement is the measure of success obtained by the students during the learning process. Success is determined by a variety of interrelated factors, including Learning Motivation, socioeconomic status and intelligence. This study aimed to analyze the influence of Learning Motivation, Socio-Economic Status of Parents and intellectual intelligence on student learning achievement Jatiguwi SDN 3 Sumberpucung Malang. Analyzing between Motivation, Socio-Economic Status of Parents and Intellectual Intelligence the dominant influence on student learning achievement Jatiguwi SDN 3 Sumberpucung Malang. This study included in the category of research explanations. The number of samples in this study were 48 students. Data analysis technique used is multiple linear regression analysis. The analysis showed that Learning Motivation, Socio-Economic Status of Parents and intellectual intelligence simultaneously and partially significant effect on student learning achievement Jatiguwi SDN 3 Sumberpucung Malang. Among Motivation, Socio-Economic Status of Parents and Intellectual Intelligence the dominant influence on student learning achievement Jatiguwi SDN 3 Sumberpucung Malang, intellectual kecerdasaran

Spiders are one of the most diverse and ubiquitous group of animals. Despite being one of the most diverse groups of animals existing in India, their study has remained largely neglected. The present research paper provides a preliminary report on spider fauna of Ahmednagar city, M.S. India. Spider specimen were collected from different localities in and around the city during July 2015 to March 2016. Total 25 spider species representing 9 families and 19 genera were recorded. Results obtained shows that the Araneidae is the most represented family with 11 species followed by Salticidae, Oxyopidae and Lycosidae (03 species each) and 01 species each from Hersilidae, Pholcidae, Eresidae, Tetragnathidae and Thomisidae. Araneidae is the most dominant family (44% of species) followed by Salticidae (12% of species), Oxyopidae (12% of species) and Lycosidae (12% of species). A note on medical importance of spiders was also added. The outcome of the present research work will update data on faunal resources of Maharashtra and will be helpful for future researchers working on the spiders of the area. The findings will also be helpful for taxonomic and phylogenetic studies on spiders.

OBJECTIVE: The study was done to evaluate the efficacy of ormeloxifene in medical management of dysfunctional uetrine bleeding. METHODS: Thirty women in reproductive age group who have completed child bearing, attending the outpatient gynaecology department with complaint of heavy menstrual flow were recruited for the study over a period of one year. Ormeloxifene (60 mg) was given orally twice a week for first 12 weeks and then once a week for up to next 12 weeks. Menstrual blood loss measurement was done using pictorial blood loss assessment chart (PBAC), blood haemoglobin (gm/ dl) levels and endometrial thickness was the main measurements to evaluate the efficacy of therapy. The data obtained was analyzed using the mean and p values of less than 0.05 were accepted as indicating statistical significance. RESULTS: There was a significant reduction in PBAC score from pre-treatment and post-treatment with ormeloxifene (p˂0.001).There was also significant reduction in the endometrial thickness after treatment (p˂0.001).The difference in mean haemoglobin concentration of 2.02 gm/dl between pre-treatment and post-treatment.no major adverse effects were seen in the study. CONCLUSION: The results in this study showed that ormeloxifene, a non-hormonal, non- steriodal agent provides effective and favourable medical management with least side effects, suitable for the treatment of dysfunctional uterine bleeding

Background: The clinical heterogeneity of Rare bleeding Disorders (RBDs) associated with their rarity is a significant barrier to enhancing their deeper knowledge. Diagnosis, classification and adequate treatment of these disorders has been hampered by the variable clinical presentation and difficulty in recognizing affected patients, difficulty in collecting longitudinal clinical data and limits of laboratory assays. The objective this study is to evaluate the distribution of RBDs amongst inherited bleeding disorders and approach to RBDswith clinical evaluation & lab diagnosis. Materials and methods: This is a Retrospective study of rare bleeding disorders obtained from the cases referred from Karnataka Haemophilia Society to the Haematology section of department of Pathology, JJM Medical College, Davangere from June 2006 to June 2011. Results: Out of the total of 400 patients of inherited bleeding disorders referred, 23 were diagnosed of RBDs which included 11 cases of factor XIII deficiency, 4 of Hypofibrinogenemia, 3 of Afibrinogenemia, one each of factor II,V,VII,XI deficiency. Conclusion: RBDs poses significant social problem in our country. Lab diagnosis of these disorders is complex but basic coagulation set up with high clinical suspicion can take up the challenge of diagnosing these disorders.

The variations in the structure and position of the kidney along with variations of renal vessels are reported by anatomists, surgeons and radiologists. Routine human cadaveric dissection showed a bilateral ectopic kidney with accessory renal artery was observed. Malrotation of both kidneys and altered anatomical structures in the hilum were observed. The both kidneys are located above the bifurcation of common lilac arteries. The Accessory renal arteries were arising from the abdominal aorta and supply both the kidneys. The renal veins draining into inferior venacava. Ectopic kidney with rotational variation of accessory renal arteries is comparatively very rare. This may be asymptomatic or present with vague symptoms and sometimes remain unknown during the lifetime. These variations have an embryological basis and are clinically significant. Knowing such variations are important for general surgeons, gynecologists for performing various surgical procedures like laparoscopic surgeries and useful for the nephrologists when dealing with radical nephrectomy and renal transplantations

The urine is frequently among the sites colonized hospital and Candiduria still poses problems of interpretation. Indeed, the discovery of yeast in the urine can be the witness of contamination, a simple colonization or the first sign of invasive infection. We report the case of an elderly patient de66ans hospitalized in urology for management of bladder cancer who underwent radical cystoprostatectomy more bilateral lymphadenectomy and entérocystoplastie.Le patient was taken to dropping a point of ileo-ileal anastomosis responsible liquidiennes food and leaks then the patient was transferred to intensive care. During his stay he presented a febrile syndrome, ECBU objectified candiduria Candida albicans. The evolution was marked by the installation of a septic shock, blood culture came back positive for Candida albicans. Fluconazole has been started but the patient is décédé48h after. Candiduria may be a marker of dissemination in patients at risk with a high severity score. She was also associated with candidemia in 1.3 to 10% depending on the study. In subjects in ICU Candiduria could predict Candida invasion and should justify antifungal treatment and a close monitoring for mycological diagnosis precocity and better therapeutic management.

The revolving door policy has become a bottleneck for the Hotel Managers. Be it the lower level staff or the top management staff, they leave the organization once they are trained and groomed as per the hotel standards. This crisis leaves the hotel at catch 22 situations. They have no option other than to hire a new staff and train them. “The Bureau of Labor Statistics [1] estimates an annualized employee turnover rate of 73.8% in the hotel and motel industry. This figure is striking consider most HR experts agree a healthy turnover rate should actually be somewhere in the 10-15% range”. Considering the high rate of attrition, training a new staff as per the standard policies becomes a costlier challenge for Hotel Industry. There are various reasons behind turnover i.e. Job dissatisfaction, better career growth/opportunities etc. There are a variety of reasons why an employee would consider quitting his or her job within the hospitality industry. These have been identified and researched significantly in the past 60 years (Brown et al., 2015; Huselid, 1995; Kang et al., 2015; Mobley, 1982; Poulston, 2008; Smith and Watkins, 1978) [2]. Yet, organizations are continually trying to identify areas for improvement regarding turnover as turnover costs can be extremely expensive. In fact, they are sometimes considered the highest cost an organization has to endure (Tracey and Hinkin, 2008; Woods, 2002).

Dyslipidemia is a common finding in patients with thyroid disease, explained by the adverse effects of thyroid hormones in almost all steps of lipid metabolism. Clinical hypothyroidism, through different mechanisms, are associated with lipid alterations, mainly concerning total and LDL cholesterol and less often HDL cholesterol, triglycerides, lipoprotein (a), apolipoprotein A1, and apolipoprotein B. In addition to quantitative, qualitative alterations of lipids have been also reported, including atherogenic and oxidized LDL and HDL particles. In thyroid disease, dyslipidemia coexists with various metabolic abnormalities and induce insulin resistance and oxidative stress via a vice-vicious cycle. The above associations in combination with the thyroid hormone induced hemodynamic alterations, might explain the increased risk of coronary artery disease, cerebral ischemia risk, and angina pectoris in older, and possibly ischemic stroke in younger patients with overt or subclinical hyperthyroidism. This article presents a correlation study between hypothyroidism, Apo B and Apo A. It has been found that the 55 subjects enrolled in this study show a significant correlation between TSH and Apo B.

This study aims to find out how the basic idea of the existence of a Reviewing Institution in criminal proceedings in realizing legal certainty and justice; Implications of the decision of the Constitutional Court Number 66/PU-XIII / 2015 and the formulation policy on future review of the Criminal Procedure Code. This research is normative legal research. The approach used is the law approach; conceptual approach and comparative approach. The results of this study are: In accordance with the nature of the final and binding decision of the constitutional court, the Constitutional Court Decision Number 66 / PU-XIII / 2015 refers to the fundamental principle that justice is the highest legal objective. Citizens' rights as guaranteed by the constitution must not be restricted because they are guaranteed by the constitution. Based on a comparative formulation study in several countries such as in the Chinese Criminal Procedure Code and the Dutch Criminal Procedure Code, the regulatory norms regarding the number of times the Submission of Judicial Review may be submitted are not formulated but the KUHAP of the two countries further regulates in detail the mechanisms and procedures for the Judicial Review. Then the policy formulation of norms for reviewing the KUHAP in the future in addition to referring to the comparison but also must be constitutional in accordance with the decision of the Constitutional Court Number 66 / PUU-XIII / 2015.

Lupus podocytopathy is a recently described phenomenon characterized by diffuse foot process effacement without peripheral capillary wall immune deposits and glomerular proliferation. It has been described in systemic lupus erythematosus patients with nephrotic syndrome in case reports and a few series. The term of lupus podocytopathy denotes that it as lupus nephritis-related phenomenon, however, the theory of coexisting minimal change disease is also a possibility. Each theory has its own supporting clinical and pathological facts. This literature review is made for a comprehensive analysis of the available clinical circumstances and histological data of the reported cases. Also, it elaborates on the pathological background for both diseases process. The aim of this review is to reach an optimum categorization of this phenomenon.

Purpose: To investigate the effect of using mucoperiosteal-bone flap split technique when width of alveolar bone ridge is insufficient. Methods: The width of alveolar bone ridge is 3-5mm. Patients underwent mucoperiosteal-bone flap splitting. A horizontal incision was made at the top of the alveolar ridge, and two vertical incisions at the mesio-distal alveolar bone, and the whole layer of the periosteum was cut through. The cortical bone was cut using an ultrasonic scalpel. As a result, the mucoperiosteal-bone flap was split. Results: The narrow alveolar bone was succeeded to be split. And gingiva was not recessionary, split bone was not necrotic after operation. Conclusion: Mucoperiosteal-bone flap split technique can solve the problem of insufficient bone width.

Background: Pertussis is a life-threatening type of infection in non-immune infants younger than six months of age. Vaccination of pregnant women with tetanus, diphtheria, and pertussis vaccine (Tdap) may facilitate the transfer of maternal antibodies to the fetus, this method may provide protection against pertussis in these newborns. This study will examine the seroprevelance of Bortedella pertussis antibodies in pregnant Saudi females. Methods: This is a crosssectional study in which 258 pregnant females of different age groups in the second and third trimesters who underwent antenatal checkups at King Saud University Medical city, Riyadh, between April 2017 and March 2018 were enrolled. Serum levels of B. pertussis antibody were measured using the enzyme-linked immunosorbent assay (ELISA) technique. Results: From 258 blood samples,234(90.69%) females between 28 and 45 years of age were non immune to pertussis,12(4.6%) showed borderline immunity, and 12(4,6%) were immune. Conclusion: The majority of tested pregnant Saudi females were non-immune to B.Pertussis despite the expanded Saudi program of immunization (which recommends that the last dose of DTap be given to preschool-age children). This study emphasizes the importance of implementation of Tdap vaccination program in pregnant Saudi females.

Salary is one form of compensation from an organization that is given to employees for their performance. The compensation could be financial or other forms. By compensating the expected performance of teachers will increase.A form of compensation given that the salary, allowances, incentives, benefits and nonfinancial. Salary is given by considering the employment status, the number of teaching hours and the long term. The benefit there is in the form of structural and functional. Incentives in the form of bonuses, extra overtime, official travel, other forms related to job performance. Compensation that is in the form of a death benefit and the cost of delivery. For non-financial compensation in the form of vacation and recreation. The constructed compensation system is to assign a job analysis component, set the level of compensation and the granting of compensation, as well as a review of compensation. Performance educators/teachers with the implementation of their compensation systems increased to more discipline and enthusiasm in guiding learners to get good performance