This study examined the impact of derivative instruments on risk management in the Nigerian banking sector, between 2014 and 2018. Ordinary least squares (OLS) model was employed to analyze data and draw inference; data used were elicited from Central Bank of Nigeria Statistical Bulletin of 2018 and Nigerian Stock Exchange Statistical Bulletin of 2018. The study employed foreign exchange derivative as proxy for derivative instruments (independent variable), while exchange rate was employed as a measure of risk management in the Nigerian banking sector (dependent variable). The inferential result suggested that financial derivative impacted positively and significantly on risk management in the Nigerian banking sector.

Background and objectives: Blended learning (BL) is positive development in education. This method provoke the learner’s critical thinking and given different ways for implementation of their knowledge in real life. There are several advantages of blended learning to the faculty, students and institutions as well. Methods: The Cross-sectional study design was used to collect data from nursing students. The study was carried out at Lahore School of Nursing, The University of Lahore, Pakistan. All nursing undergraduates students enrolled at elective practicum blended learning course at Lahore School of Nursing, The University of Lahore, Pakistan academic year 2016-2017 were included in the study. The tool was adopted from Roca et al., 2006 and Song 2010 study. Results: About 65% of students showed positive response towards the information quality of course, student’s usability of elective course, satisfaction with course and perceived usefulness of elective practicum blended learning course. Conclusions and Recommendation: Students had well believes about elective practicum blended learning course. Moreover, enrolled students agree with the statements of usability of blended course and overall showed satisfaction with elective practicum blended learning course. Blended learning significantly improve the learning of the students and provides the space for better skills in the clinical setting simultaneously. Institutions, policy makers and regulatory bodies should incorporate this strategy in the nursing curriculum in Pakistan.

Backgroud: Osteomyelitis is an inflammatory process of bone and bone marrow contents. Bone changes are primarily seen in the soft tissue followed by the calcified tissue. It is usually caused by pyogenic bacteria or mycobacterium. Objective: To determine the epidemiologic profile of patients with osteomyelitis admitted at a tertiary centre from 2006 to2016. Methodology: The present study was done retrospectively in which the data was collected from the year 2006- 2016 from a tertiary centre and analyzed epidemiologically. Result: The female patients outnumbered the male patients and most of the patients were in their 3rd and 4th decade. Also, the maxilla was more commonly affected thand mandible. Conclusion: The study helps in assessment of the local data of a tertiary centre which is important in optimizing the local therapeutic protocols.

Laser is an acronym for light Amplification by Stimulated Emission of Radiation. Several decades ago, the laser was considered like a death ray, the ultimate weapon of destruction, something you would only find in a science fiction story. Then, lasers were developed and actually used, among other places, in light shows. The beam sparkled; it showed pure, vibrant and intense colors. Today the laser is used in the scanners at the grocery store, in compact disc players, as a pointer for lectures and above all in the medical and dental field. The perception of lasers has moved from the comical death ray to the more useful ray for development of health sciences

Backgroud: Aspirin is the generic name of Acetylsalicylic acid (ASA). It is an analgesic, antipyretic, anti-inflammatory. It also has an antiplatelet action and therefore this drug is used in the prevention and treatment of thromboembolic diseases. In order to avoid the excessive bleeding and to be on the safer side, dentists have traditionally advised their patients to stop taking aspirin before extraction of teeth although this surgical procedure can be done without cessation of aspirin intake and if the clinician wishes to stop the aspirin therapy, it should not exceed more than 3 days prior to the dental procedure. Objective: The purpose of the present study was to assess the time required for hemostasis if the low dose (150 mg once daily) aspirin therapy discontinued 3 days prior to dental extraction. Methodology: A cross sectional study was conducted which comprised of 40 subjects who took low dose of aspirin (150 mg) once daily. The blood pressure of all the subjects was recorded preoperatively. The extractions were done atraumatically under local anesthesia using 2% lidocaine with 1:100,000 epinephrine. The postoperative bleeding was controlled by the pressure pack. Result: Among 40 patients, the postoperative hemostatic time of 82.5% subjects was less than or equal to 10 minutes while that of 17.5 % was more than 10 minutes. The bleeding was successfully managed by the pressure pack. Conclusion: Reviewing most of the dental and medical literatures, it can be concluded that there is absolutely no need to discontinue aspirin therapy for any ambulatory dental procedure, and even if the practitioner wishes to discontinue, it should not be for more than 3 days. This is also stated in the guidelines of the American Heart Association. Therefore, it can be assumed that the dental extraction can be done without long cessation of low dose aspirin and avoiding the life threatening issues.

With the growing population of cancer survivors, the concept of quality of life (QOL) has become important. Chemotherapy-induced peripheral neuropathy (CIPN) is one such common, ailing chronic condition characterized by tingling senstaion, pain and sometimes decreased function of hands and foot, which hampers the QOL of patients post chemotherapy treatment. A PubMed search for ‘chemotherapy-induced peripheral neuropathy’ was done. Despite the volume of recent publications, there are limited preventive or therapeutic strategies for CIPN supported by high-level evidence. Recently the effect of alternative non-pharmacological therapeutic approaches and predictive biomarkers have been explored.As CIPN still affects a mojrity of patients’, there is a need for critical analysis of the literature. The present study aimed to review the literature on chemotherapy-induced peripheral neuropathy and its treatment or other possible interventions.

Squamous cell carcinoma (SCC) is the most frequently encountered malignancy by head and neck surgeons. There are certain variants of SCC that are classified as individual tumours by the World Health Organization (WHO).The histopathologic picture of these malignant tumours guides the surgeon in evaluating the prognosis. These variants require special attention owing to fact that there’s gross difference in their presentation and management. Ackerman’s tumour is the most commonly encountered variant. A case of Ackerman’s tumour involving the hard palate and lower labial mucosa is discussed

Background: With the advancement in medical facilities and sudden drop in mortality rate, the elderly are the most rapidly growing population group in the world. On contrary in industrialized societies, blood pressure increases with age, and blood pressure at one age is directly related to blood pressure at an earlier age. Blood pressure is also related to weight, weight change, and maturation. This study is to correlate the association of growth and maturation with blood pressure and the evidence for blood pressure "tracking" with age. Additional longitudinal studies are required to determine if blood pressures before puberty are related to blood pressures of sexually mature young adults. Materials and method: Prospective randomized sampling was done to include all the patients who came for the dental treatment and their systolic and diastolic blood pressure were recorded. Patients were then divided in 5 groups: group A (21 -30), group B (31 -40), group C (41- 50), group C (51 -60) and group D (61 -70) years of age. Patients who had gestational hypertension, patients already diagnosed with hypertension and on medication for same were excluded. All the five groups consisted of 20 patients each. Results: A total of 100 patients were evaluated pressure within 5 five groups for systolic and diastolic blood pressure. Over all mean blood pressure of 100 patients were 128/86 mmhg whereas among Group A, B, C, D, E and F mean blood pressure was 118/78, 122/84, 133/88, 130/84 and 138/94 mmhg. Results shows low mean blood pressure among Group A (age group of 21-30) patients that is 118/78mmhg and highest among group F (age group of 61- 70) that is 138/94 mmhg. Conclusion: With the advancement of age blood pressure also raises up which can be alarming for other progressive systemic diseases. One should have regular check-up, changes in diet and behaviour life style as age advances.

Purpose: This study assesses the influence of four styles of instructional delivery on dental students‟ preference and perception of learning experience using lecture method in classroom setting. The association between gender, age, course level and the instructional method preference is also evaluated. Materials and Methods: A group of 98 undergraduate students belonging to the first three years of Bachelor of Dental Surgery (B.D.S) degree program participated in this study. Four instructional methods were used to deliver lectures on surgical techniques used in dental implantology: Chalk-talk method (CT), PowerPoint presentation with figures (PPTf), PowerPoint presentation with figures and dental models (PPTfm) and Videos-verbal elaboration (VT). Two structured questionnaires were used to record the response of the students towards the instructional method employed. Descriptive statistics and chi-square test were used. Results: Recorded students‟ response indicates that VT is an effective instructional delivery method to deliver subject content (99%), promote topic understanding (98%), promote future learning (99%), promote recollection (99%), promote integration of theoretical and practical knowledge (98%) and promote attentiveness (100%). The order of lecture methods preference is as follows: combination of instructional delivery methods (49%), VT (44.9%), PPTfm (5.1%), PPTf (1%) and CT (0%). As the course level increased, higher preference was given to combination of instructional delivery methods (PPtfm, PPTf, VT). There is statistically significant association between age and the method preferred (p=0.001). Conclusion: The dental students preferred the VT method, followed by the PPTf and PPTfm methods.

This study investigated the influence of Information Communication Technology (ICT) in teaching and learning Geography in selected tertiary institutions in Adamawa State, Nigeria. The study specifically sought to determine if Geography teachers in tertiary institutions are exposed to new technologies, establish whether new technologies are available for teaching Geography, investigate the extent of integration of these new technologies into teaching Geography and examine the factors that inhibit teachers from using new technologies in teaching Geography in selected tertiary institutions in Adamawa State. The study adopted a descriptive survey design and the population consisted of students of three tertiary institutions in Adamawa State. Three hundred respondents were selected using stratified random sampling technique. The instrument titled: „Information and Communication Technology in Teaching and Learning Geography Questionnaire‟ was validated by an expert in Guidance and Counselling from the Department of Science Education. The reliability value was calculated using Kudden Richardson formular (KR-21) which yielded reliability co-efficient of 0.87.

Planning and executing the restorative rehabilitation of a decimated occlusion is probably one of the most intellectually and technically demanding tasks facing a restorative dentist. The term "occlusal rehabilitation has been defined as the restoration of the functional integrity of the dental arches by the use of inlays, crowns, bridges and partial dentures". Occlusal rehabilitation therefore involves restoring the dentate or a partially dentate mouth. The aim is to provide an orderly pattern of occlusal contact and articulation that will optimize oral function, occlusal stability and esthetics. Occlusal adjustment by grinding may be required, as part of the rehabilitation but does not constitute rehabilitation per se. In this review occlusal rehabilitation is discussed in the context of cases where restorations are supported by natural teeth and doesn't include the restoration of the fully edentulous arch or maxillofacial defects, nor does it include the use of osseointegrated implants.

Background: Left ventricular (LV) thrombus is a complication of acute Myocardial Infarction (MI) and is associated with systemic thromboembolism. Although standard trans-thoracic echocardiogram (TTE) is commonly used for screening, it is limited by low sensitivity for detection of LV thrombus. Magnetic resonance imaging has a high yield in detection of these thrombi. Objective: To determine rate of detection of left ventricular thrombi on magnetic resonance cardiac viability studies. Design: Retrospective, observational. Setting: Department of Radiology at a Hospital in Dhahran from April 2013 to April 2018. Patients and Methods: All recently reperfused ST Segment Elevation MI (STEMI) patients who were referred for MR cardiac viability studies with negative TTE (for LV thrombi) were evaluated. Patients with limited or incomplete studies, previously known MI or cardiac surgeries, and those contraindicated to MRI were excluded. An area of low signal intensity with no late gadolinium enhancement (LGE) was defined as thrombus on MR imaging, and two radiologists made consensus reporting for the diagnoses. Patients with anterior or non-anterior wall MI were documented, and their ejection fractions were recorded. The percentage estimation for positive LV thrombi cases was made. Any complications (like stroke or death) that occurred within one year of diagnoses were documented. A Chi-square and t-test determined the association. Main Outcome Measures: Detection of LV thrombi. Sample size: 125 patients. Results: Of the 125 patients, most were men (71.2%) with a mean age of 56.78 years. Eleven patients had left ventricular thrombi (8.8%), and most of these were anterior wall infarctions with low ejection fractions (<40%). Three out of 11 patients with LV thrombi developed complications versus 3 out of 114 without LV thrombi. Conclusion: Cardiac MR viability studies can detect LV thrombi in recently reperfused echo-negative STEMI patients. Limitations: Retrospective, small sample, single center, use of non-contrast echocardiography

Background: Stress is a negative emotional, cognitive, behavioral and physiological process occurs as individual adjusts with stressors. Due to the secretion of this cortisol and epinephrine blood vessels are tightenedas a result heart rate and blood pressure increases. Present study aimed to asses the level of perceived stress and its association with Pre hypertension in health professional beginners. Material and Methods: A cross sectional study was conducted in the Department of Biochemistry, SBKS MI & RC, SVDU for consecutive two batches 2016-17 & 2017-18. Total 506 first year MBBS, BDS & BPT students were studied for age, gender and Blood Pressure. Stress was assessed by PSS-10 scale. Two groups were identified as their PSS score, stressed and non-stressed. Results: PSS score showed that among all participants 71.74% (N=363) students were stressed and 28.26% (N=143) students were none stressed. In the present study the mean systolic blood pressure and diastolic blood pressure of 506 health professionals was 125.63±3.35 and 76.96±5.65 respectively which falls under the category of pre hypertension. Conclusion: Majority of students could be categorized as pre-hypertensive group based on blood pressure.An effective inclusion and implementation of regular exercise, sports and cultural activities and stress management program like meditation, yoga in the medical curriculum may be a key to reducing and or preventing stress-induced psychological distress and Hyperteinsion

Soft tissue sarcomas (STS) are a rare a highly heterogeneous set of malignant mesenchymal neoplasms. Histological grading plays a central role in the assessment and management of patients with STS, since histological gradeis prognostic, contributes to clinical staging, and is also predictive of chemotherapy responses so drives clinical decisionmaking on the use of adjuvant chemotherapy. Here we review the main histopathological grading systems andthe main considerations for the practising pathologist when grading STS. We highlight that histological STS gradingis not without its limitations, not least in classifying 50% of tumours as of uncertain behaviour (grade 2). However, recent developments in molecular risk stratification hold promise for molecular grading of STS with the ultimate goal of personalising therapy based on molecular profiles.

Breast spindle cell lesions (BCSLs) are a highly heterogenous group of diseases that frequently challenge the diagnostic skills of even specialist breast pathologists. While a systematic morphological assessment remains central to narrowing the differential diagnosis, immunohistochemistry (IHC) is a valuable ancillary test that can help to either further narrow or confirm a diagnosis. However, BSCLs can also show a remarkable degree of intra-tumoural morphological and immunohistochemical heterogeneity, meaning that IHC is rarely either specific or sensitive for a particular lesion and that care must be taken when interpreting diagnostic core biopsies. IHC results must, therefore, always be interpreted with caution and in the context of the morphological features and wider clinicopathological findings.