Background: There is evidence that support the use of high sensitive C-reactive protein (hs-CRP) to monitor cardiovascular risk in diabetic and non diabetic individuals. This study aims to assess hs-CRP level in Sudanese with type 2 diabetes mellitus (D.M) and obese individuals; as a risk factor for cardiovascular diseases. Materials and methods: This cross-sectional study was conducted in Khartoum-Sudan from April to December 2018, 50 diagnosed Sudanese patients with diabetes mellitus attending Alarbaeen hospital in Khartoum state and 50 obese Sudanese individuals were enrolled in this study. Blood samples were analyzed for cholesterol and hs-CRP levels using Mindray BS-200 automated analyzer. Results: There were no significant differences in hs-CRP and total cholesterol levels in type 2 D.M when compared with obese. Both diabetic patients and obese had high levels of hs-CRP and total cholesterol. hs-CRP and total cholesterol levels revealed no significant difference when male compared with female in type 2 D.M as well as in obese. The majority of the study participants were found to have hs-CRP level more than 3 mg/L, which indicate a high risk to have cardiovascular diseases according to American Heart Association. There was no correlation between hs-CRP levels and total cholesterol levels in the study subjects. Age showed inverse significant correlation with hs-CRP levels in type 2 D.M and no correlation among obese. In conclusion: The higher levels of hs-CRP with higher levels of total cholesterol may be a predictive factor for developing of CVD in Sudanese with type 2 D.M as well as in obese.

Ischemic colitis goes unrecognized as a complication in intestinal neoplastic disorders because of their unique morphological features which vary depending upon haemodynamic status. The two cases presented here show even though ischemic pathogenesis is the underlying factor responsible for this condition; morphologically they are heterogenous and they are described in detail.

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.

Burns are one of the most common and devastating forms of trauma. Patients with serious thermal injury require immediate specialized care in order to minimize morbidity and mortality. Data from the National Center for Injury Prevention and Control in the United States show that approximately 2 million fires are reported each year which result in 1.2 million people with burn injuries. The present study, “Bacteriological profile of burn wound infections” was carried out in Department of Microbiology, in a tertiary care hospital, over a period of one year from Jan 2016 – Dec 2016. A total of 50 patients of all age groups and both sexes admitted in our Burn Care Unit were selected for this study. In the present study, Majority of patients were in the age group 31-40years. Out of 50 patients studied, 28 patients were male and 22 patients were females. A total of 128 organisms were isolated and Pseudomonas aeruginosa (44 cases) was the most common isolate followed by Staphylococcus aureus (37 cases) and coagulase negative staphylococci (29 cases). The other isolates included Klebsiella pneumonia, Escherichia coli, Proteus mirabilis, Citrobacter freundii and Enterococcus species. Modern infection control practice has been effective in reducing or eliminating endemic pathogenic and/or antibiotic-resistant organisms, preventing the establishment of newly introduced pathogenic and/or antibiotic-resistant organisms as the predominant nosocomial flora of the burn unit, and preventing reseeding of such strains back into the burn unit from patients housed in the adjacent convalescent ward.

In Cameroon, due to the weaknesses of institutions and inadequate laws, many agro industrial plantations which are in most parts of the country extensively apply fertilizers, pesticides and discharge their untreated waste into nature. These attitudes are consistent for industries, hospitals and individuals. Consequently chemicals are found in ground water. Artisan mining of gold in the South eastern and Eastern parts of Cameroon release substantial quantities of arsenic in to ground water. All these leads to ground water pollution .The ramification of this pollution of ground water is water borne diseases (such as typhoid, cholera and amoebic dysentery which are recurrent in most of the urban cities in Cameroon). This paper investigates why the laws regulating ground water are not enforced and the lacunae of these laws. The paper does so through a reading of records mainly from documentary and internet search. The data thus collected constitutes the sources from which the law is drawn, stated and analyzed in the light of the stated aim of the paper. The results inter alia show that the law that regulate ground water pollution are not well enforced. The said results also highlight the limitation of the available laws regulating ground water pollution in Cameroon. The results are significant as they expose gaps in the current laws regulating ground water pollution and conclude with suggestions on where the law should go.

This study aims to analyze several decesive determinants such as; direct compensation, indirect compensation, and employee status toward employee performance at PT. XYZ engaged in telecommunications infrastructure. The population of this study is all the employees in the business unit of PT. XYZ who are 56 employees, due to the total population is not greater than 100 respondents, the research sample is 100% of the population in the business unit of PT. XYZ. Data collection techniques used in this study was using questionnaire instruments which distributed to respondents in the business unit of PT. XYZ was held in November 2017 until March 2018. The data analysis technique used multiple regression analysis by using SPSS 24.0 to test the hypotheses, classic assumption test, reliability, instruments validity or measuring instruments which used. The finding in this study indicates that direct compensation, indirect compensation, and employee status have a significant and partial effect toward employee performance of PT. XYZ. This research certainly also has a number of managerial implications which are the practitioners must pay more attention to employee performance appraisal programs, providing compensation related to mandatory allowance, non-compulsory allowance, and program benefit which also defining a career path that is evident for the contract employees must be translated in employee career planning, so that all the employee are motivated to achieve their career goals in accordance with the target and the implementation of compensation online dashboard which must be performed by PT. XYZ, so that employees can access their right and obligation transparently or openly

Healthcare-associated infections (HCAI) are a major setback for any organization. The most important mechanism of spread of these HCAI is via the contaminated hands of the healthcare givers that is doctors, nurses, other staff or relatives/friends of the patients. Contaminated environmental surfaces are another important reservoir for the spread of these infections. However, they are often under recognized. HCA is one of the most important public health problems in most countries of the world. In any healthcare setup basic infection control, measures can reduce the rates of healthcare-associated infections, which help to reduce the length of stay, nosocomial infection and cost. It is important to implement the quality system which can be executed and monitored by using compliance measures in the routine process of the hospital in order to improve the standard of patient health care. The quality of hospital infection control program is a reflection of the overall standard care provided by the institution. The current study is aimed to help in assessing the pre-existing knowledge regarding infection control practices among doctors and nurses. In our study, both doctors and nurses had a fair knowledge about the spread of nosocomial infections, practised safe patient-care protocols, and had positive attitudes. Still, some gaps have been identified in their knowledge and practice of infection control. It is suggested that an effective training sessions should be organized at the time of hire and in-service periodically which might help to decrease the healthcare associated infections.

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.

Nowadays the automotive industry in Indonesia is becoming increasingly competitive, causing an intense competition among the ATPM (Single Agent of Brand Holders), as well as competition between existing automotive manufacturers (sole agent) and newcomers. In the midst of the current business industry and its competitive environment, various strategies were implemented by the company in order to maintain its customers, and to win the competition by increasing its market share. Customer satisfaction has become one of important focus for many companies. This study aims to examine and analyze the effect of product quality and after-sales service on customer satisfaction at an authorized Mazda Serpong Dealer, Tangerang. The sample used in this study were 200 respondents from customers at Mazda Dealer Serpong, Tangerang. Sample size determination using Hair’s formula. Hypotheses of the study analized by using multiple linear regression performed with SPSS 2.4. The sampling technique uses purposive sampling. The results showed that the quality of the product significant and positive affect on customer satisfaction. And after-sales service is also significant and positive affect to customer satisfaction. Other results shows that the quality of products and after-sales service of significant and positive affects on customer satisfaction simultaneously

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.

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%.

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.

Aim and Objectives: The aim of this study was to determine the cephalometric skeletal and dental norm for orthognathic surgery for North Indian population using Burstone’s analysis and to test the hypothesis that there are racial and ethnic differences in cephalometric measurements between North Indian and Caucasians. Materials and Methods: A total of 120 young adults which consists of 66 males and 54 females, 18 26 years with well-balanced facial profile and minimum arch length discrepancies were chosen for the study. Lateral cephalograms with teeth in maximum intercuspation were recorded and analyzed with AutoCeph software. The mean values of cephalometric skeletal and dental variables of COGS (Cephalometrics for Orthognathic surgery analysis) analysis for North Indian males and females were compared with those Caucasians. P < 0.05 was considered to be statistically significant. Statistical Analysis: The statistical difference in the values of parameters between males and females of North Indian population was analyzed using unpair ‘t’ test whereas the difference between the study population and Caucasians was analyzed using one sample t test. Results: All the cephalometric parameters were found significantly less except convexity angle, maxillary and mandibular dental proclinations, occlusal plane angle. Maxilla and mandible was found prognathic and greater chin prominence in North Indian population compared to Caucasians. Conclusion: Significant difference in the cephalometric characteristics were found between Caucasians and North Indian population. Gender and racial/ethnic differences should be considered for diagnosis and treatment planning for orthognathic surgery for North Indian population.

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.

The strategy is a plan, implementation, and control in achieving long-term goals. Strategic management is an effort to achieve certain goals through the activities of others so that coordination is needed for the activities of planning, staffing, directing, and controlling in the long run. This study aims to develop a strategy for implementing the operational department procedures at the company PT "X" which has been standardized in the standard operating procedures integrated with computer programs. The research method used in this study is a qualitative analysis method trough interview, observation and documents. The result of analysis are operating procedures Standard of PT”X” are prepared in accordance with ISO 9001 requirements including: Control of Documents and Data (article 5), Process Control (article 9), Inspection and Testing (article 15), Identification and Product Traceability (article 18). The operating procedure standard of PT “X” is using: a. Job and activity, b. Format, c. Quality control. Standard of Operating Procedure for Marketing Division at PT. "X" consists of: Standard of Operating Procedures for Selling Consumer Shipping Services as follow: 1) Standard of Operating Procedures for Selling Consumer Services. 2) Standard of Operating Procedure for Making Shipping Services Cooperation Contracts. 3) Standard of Operating Procedure for Contract Cancellation. 4) Standard of Operating Procedure for Delay Fines. 5) Operational Standards Report Making Procedures and Performance Reporting Marketing Division. The Operating Procedure Standard of Document Management Divisipn as follow: 1) Standard Operational Procedure for Arranging the Decent Approval/Permit Document (SPB or letter of approval for shipping). 2) Standard of Operating Procedure for Document Management in the Transportation Department. 3) Standard of Operating Procedure for Port Document Management. 4) Standard of Operating Procedure for report making and performance document management division