The wearing of Charms Tolak Bala in avert is a tradition in the Malay community in the village of Bagan Serdang Subdistrict Pantai Labu.Study this study investigates about the wearing of charms tolak bala in rejecting in Malay society of Village Bagan Serdang. The wearing of charms tola kbala in avert still a culture conducted most community groups in Indonesia, either in the form of rituals, rites of Thanks giving rituals or avert. These ceremonies have become a tradition in the community in daily life that handed down by the ancestors to the generations to come. The wearing of charms tolak bala in rejecting the community activity is channelled to the traditions which continue to be developed by the Malay Village Bagan Serdang. Thus, the tradition of wearing charms tolak bala in avert performed by residents of KampungBaganSerdangSubdistrict Pantai Labu can survive because the local residents continue to use and keep them. The focus of this research include about practice and execution against the wearing of charms tolak bala. This study uses qualitative methods to get the appropriate data that is happening in the field. Data collection is done by conducting interviews with some of the respondents came from the community. The results showed that the Malay Village Bagan Serdang still trust and use the wearing of charms tolak bala in the avert and to protect themselves.

Intense competition in today's business world has made it increasingly difficult for firms to exist, and survival has become a primary business goal. Some entrepreneurs have struggled to compete, and some have eventually failed; therefore, how firms create and sustain their competitive advantage provides a sound basis for the firms’ existence. This study’s objective is to explore the resources that enhance a sustainable competitive advantage within the context of small and medium enterprises (SMEs) in creative industries. The state of competition within industries is presented using the resource-based view (RBV) and social capital, and we specify three essential competitive determinants: market orientation, collaborative external network, and managerial ties. This study used a questionnaire survey and structural equation modelling to evaluate the conceptual model. We found that market orientation and collaboration external networks can lead to sustainable competitive advantage. In addition, managerial ties as a mediator between market orientation and collaborative external network lead to sustainable competitive advantage

Maxillary reconstruction is still an evolving art when compared to the reconstruction of the mandible. The defects of maxilla apart from affecting the functions of the speech, swallowing and mastication also cause cosmetic disfigurement. Rehabilitation of the form and function in patients with maxillary defects is either by using obturator prosthesis or by a surgical reconstruction. Literature is abundant with a variety of reconstructive methods. The classification systems are also varied, with no universal acceptance of any one of them. The oncologic safety of these procedures is still debated, and conclusive evidence in this regard has not emerged yet. Management of the orbit is also not yet addressed properly. Tissue engineering, that has been hyped to be one of the possible solutions for this vexing reconstructive problem, has not come out with reliable and reproducible results so far. So, this article reviews the various recent advances in maxillofacial prostheses.

Background and Objectives: Diabetic nephropathy (DN), a common microvascular complication in diabetic patients, is characterized by gradually increasing urinary albumin excretion (UAE), and affects 20-40% of Type 2 Diabetes mellitus (DM) patients in India. The defective insulin action in the metabolism of lipoproteins leads to lipid abnormalities as well as glycation of lipoproteins cause abnormalities in the lipoprotein metabolism in Type 2 DM patients. Dyslipidemia causes glomerular injury which will lead to progression of proteinuria. Methods: 100 Type 2 Diabetic patients with not less than 10 years duration of diabetes were selected and divided in three groups; Normoalbuminuric (n=42), Microalbuminuric (n=41) and Macroalbuminuric (n=17). Lipid profile, HbA1c, S. Creatinine and Urinary Albumin Excretion (UAE) were measured and data analysis was performed. Result: Total Cholesterol (TC), Triglyceride (TG) and LDL-C levels were not significantly associated with increase in proteinuria. HDL-C levels and TG/HDL ratio were significantly associated with different stages of proteinuria. Conclusion: HDL–C levels and TG/HDL ratio can be considered an excellent tool and approach for estimating risk of development of overt proteinuria among Type 2 diabetes patients.

Vascular Endothelial Growth Factor (VEGF) is closely related to tumour progression and prognosis. This study aims to evaluate the pattern and clinical implication of VEGF expression in benign and malignant neoplasms and to determine the effect of surgery on serum level of VEGF. Cases were drawn from among histologically confirmed orofacial tumours, while controls were from consecutive, ambulatory dental patients at the University of Benin Teaching Hospital. Blood samples taken from cases and controls, preoperatively and at one -month post-surgery, were allowed to clot and the serum aliquots stored at -600C till analyses. Serum VEGF was analysed using Sandwich ELISA and mean levels as well as median were measured. Spearman correlation was estimated, t-test measured significance (at p ≤ 0.05). Eighty-one subjects were studied (55 cases and 26 controls). Preoperatively, there were significantly different serum levels of VEGF in benign (48.11 ± 25.19 pg/ml) vs. malignant cases (1065.00 ± 412.14 pg/ml), and when compared with controls (45.42 ± 29.83 pg/ml), p <0.001. After definitive surgical intervention, there was a significant reduction in the level of serum VEGF in both benign (45.50 ± 24.71 pg/ml) and malignant cases (51.22 ± 16.84 pg/ml), p <0.001. One-way ANOVA revealed no significant differences between cases and controls post-surgery. There was elevated levels of serum VEGF in benign and malignant orofacial neoplasia. Surgery caused a significant reduction of circulating VEGF to normal levels irrespective of age, gender, previous medical history, perceived duration of the lesion and lymph node involvement.

Maternal mortality ratio in India is 199per 100000 births, MMR in Rajasthan is 208 per 100000 live births and MMR in Udaipur is 284 per 100000 live births (2016) [1]. Leading causes include post partum hemorrhage (30%), sepsis, unsafe abortions, rupture of uterus and obstructed labor [2]. Emergency hysterectomy in obstetrics is rarely indicated and is always debatable but if performed timely and wisely can be life saving [3]. In the present study 24 cases (92.30%) belonged to age group of 26-35 years. 22cases (84.61%) belonged to Para 3 and 4. 14 cases (53.84%) required emergency obstetric hysterectomy to control atonic post partum hemorrhage . 6 cases (23.07%) were due to rupture of uterus , 4 case (15.38%) was due to sepsis 1 case due to cervical ectopic pregnancy. 20(76.92%) were unbooked cases with no antenatal care. There was no maternal mortality. Aim of the present study is to help reducing maternal morbidity and mortality and to suggest ways of improving maternal outcome

This study is about gender representation in billboard advertisements. It analyzed how male and female were represented in billboard advertisements in Nigeria. A fleeting glance at billboards in Nigeria often show a disconnect between the models and the products they represent. This observation led to employing the social constructionist theory of representation which posits that meaning is constructed by the individual users of the language to ascertain how the males and females are represented in billboard advertising with the unit of analysis as sex, roles and dressing of the products spokesperson, and product connection. The data for this study which were gathered through content analysis of billboards and Focus Group Discussion (FGD) were analyzed using semiotic and textual analysis. This study which is both a quantitative and qualitative study found out that men are located mostly outside the home while the females were always seen within the home and less in the work environment. Again the issue of no-product connection was higher on the female side that mostly played decorative roles. This study becomes timely in the heels of the efforts towards eliminating gender discrimination and stereotypes. It is also hoped that this work will be a stepping stone for further research on gender representation in Nigerian billboard advertisements.

Introduction: The urethral catheter is one of the most vulnerable of medical devices, having been used for urine retention on an intermittent or indwelling basis for centuries. Insertion of a catheter may carry urethral organisms into the bladder. Even with meticulous attention to maintenance of the closed system, the space between the external catheter and the urethral mucosa offers opportunity for bacterial entry directly into the bladder and are eliminated efficiently; most bacterial strains that enter the catheterized urinary tract are able to multiply to high concentrations within a day. The duration of catheterization is the most important risk factor for the development of catheter-associated bacteriuria. the present study was done to assess the risk factors, occurrence and aetiology of catheter associated urinary tract infections (CAUTI) in ICU of Dr D.Y Medical College, Hospital and Research centre, by various microbiological techniques and to determine the susceptibility pattern of isolates to commonly used antimicrobial agents for prophylaxis and empiric therapy of CAUTI in patients on indwelling catheter. Results: majority of the patients (17.3%) were in the age group of 61-70years followed by 41-50 years (16.2%), 51-60 years (16%), 21-30 (14.9%), 31-40 years (14.5%), 71-80 years (11.1%), 11-20 years (7.1%) and 81-90years (2.9%). The mean age of the patients was 49.21 ± 19.04 years. 62.5% patients were male and 37.5% were female. There was male preponderance and the M:F ratio was 1.67:1. It was observed that significantly higher number of patients (6.1%) patients had the indwelling catheter for 8-14 days. There was significant association of days of catheterization and CAUTI as per Chi-square test (p<0.05). The logistic regression analysis showed that days of catheterization were independently associated with CAUTI. Conclusion: The urinary tract of catheterized patients is highly susceptible to severe infection. This infection is associated varied microbiological aetiology. Antibiotic sensitivity pattern of the pathogen involved is also low. This along with existing underlying condition of comorbidities increases hospitalization, medication, morbidity and also adds to the financial burden. Therefore, it is imperative to carry out microbiological testing to determine aetiology and ascertain effective antibiotics. Emphasis should also be made on reducing the duration of catheterization in order to reduce the incidence of catheter-related UTI. Hospital-wide surveillance program and appropriate catheter care protocols should be developed and implemented from evidence-based protocol.

Pakistan, especially NWFP, possesses huge marble reservoirs. The promotion and development of marble industry could bring prosperity and development for the country. Swat, Buner, Chitral, Kohistan, Mardan, Hazara, Nowshera and Kohat divisions are high potential areas for quality marble in the province. Mohmand, Khyber, Bajaur, Orakzai and Kurram Agencies from Federally Administered Tribal Areas (FATA) have huge marble reservoirs. Pakistan offers big investment opportunities in mining, value addition and manpower development in the sector. Recent reports suggest that Saudi Arabia is interested in Pakistani marble to build its new cities with an expenditure of around $260 billion. Italy and other countries, it is learnt, want barter trade of their marble machinery & technology in exchange for the Pakistani marble. All this shows great investment potential in Pakistan’s marble and granite sector. As an estimate of Pakistan Stone Development Company (PASDEC), 297 billion tons of Marble and Granite reserves are available in the country. More than 1,225 quarries and 2,000 processing units are operational. A group of committed business men agreed to form a Strategy Working Group (SWOG) to address how the industry can reposition itself through a better strategy. Marble is gaining popularity due to its increasing usage in construction industry. Nowadays in the modern architectural designs of houses and plazas include the final touch of marble in exterior as well as interior portions due to its attractive look. The research purpose of the study is to investigate the mechanical properties of concrete with different replacement levels of ordinary Portland Cement with Waste marble powder and natural coarse aggregates with recycled coarse aggregates. The standard cubes (150mmX150mmX150mm) were casted. Laboratory experimentation was carried out to analyze the performance of M25 grade mix cases were casted and tested. The compressive strength effect of concrete of various amount of replacement of cement viz., 5%, 10%, 15% with Waste marble powder and various amount of replacement of natural coarse aggregates with 15%, 30% and 45% with Recycled coarse aggregates. The resultant concrete was tested for parameters like compressive strength, slump and workability and compared with conventional concrete.

Asparaginase (ASP) is an effective chemotherapy agent extensively used in children with acute lymphocytic leukemia (ALL). There has been a recent interest in using ASP in adults with ALL. We present the case of a 23-year-old patient who presented with fatigue, polyuria, polydipsia associated to a bronchial syndrome and fever with vomiting and abdominal pain. The patient was on chemotherapy for his acute lymphoblastic leukemia (ALL). Blood and urine examination confirmed the diagnosis of diabetic Ketosis. A hypertriglycedemia was also found. The etiology for this both complications was most likely a result of oral glucocorticoid therapy combined with asparaginase therapy. The patient was rehydrated with saline, and antibiotics were administered to treat his infection. He was then slowly brought to euglycemia with sub cutanous insulin injections. Although these complications are relatively rare during the treatment of ALL ( prevalence of 10%), frontline providers should be aware of these side effects because delayed diagnosis may lead to a more severe complications such as ketoacidosis or hyperosmolar hyperglycemia with risk of hypovolemic shock and death

The worldwide production of coal ashes is estimated to more than 800 million tonnes in 2012. Coal use is forecast to rise over 50% to 2030, with developing countries responsible for 97% of this increase worldwide. The estimated worldwide production of coal ashes is around 13.33 billion tonnes in 2030. The reuse rate for fly ash is around 47% whereas the reuse of bottom ash is only around 5.28%. It has contributed to environmental problems such as contaminating ground and surface water due to the limitation of dumping space, where it is still treated as waste and put in impoundment ponds, silos or landfills. By using Coal waste to replace cement production, the environmental benefits will occur and lead to a decrease in CO2 emissions by 0.9 tonnes for each ton of fly Ash used. According to the Environmental Protection Agency (EPA), living next to a coal ash disposal site can increase the human health risk of cancer or other diseases. It can also affect drinking water from a well where humans may get cancer from drinking water contaminated with arsenic. In Malaysia, there is seven coal-fired electric power station for the time being. In Peninsular Malaysia, there is four coalfired electric power station that produced at least 1400 MW of electric power. Coal waste is produced which includes coal ash in the fraction of about 75-85 % Fly Ash (FA) and 15-25 % Bottom Ash (BA). The study was conducted using the waste products from Tanjung Bin power plant which located in Mukim Serkat, Daerah Pontian, Johor, Malaysia that started operation in September 2006 with a capacity of (2100MW) electricity generating capacity. It is one of the four thermal power plants that utilize pulverized coal in the generation of electricity. Tanjung Bin power station produces 180 tonnes per day of bottom ash and 1,620 tonnes per day of fly ash from 18,000 tonnes per day of coal. This study presents the results of an experimental investigation on the probability of using Bottom-ash products in producing Fly-Ash bricks. By substituting 20% of cement with FA and fine aggregate (river sand) with partial replacement of 5%,10%,15% and 20% of BA where sand replacement can save the natural sand resources from depletion and also reduce the coal ash (CA) in Malaysia which classified under the Scheduled Waste (SW 104) Environmental Quality Act. The results of compressive strength at 7,14 & 28 days of air curing showed that the compressive strength and flexural strength decrease with the increasing of sand replacement of the bottom ash while noticed a visible increment of the water absorption ratio with increasing BA percentage wheras density shows the opposite of that.

Background: Tako-tsubo syndrome is an increasingly common cause of perioperative left ventricular dysfunction. It’s often transient and reversible. Until then, it mainly affect elderly patients but recently it begins to spread to a younger population. Case report: we report the case of a young female patient with takotsubo cardiomyopathy following a simple Laparoscopic abdominal surgery

Dental implants are in dynamism of the new world. Different systems are available in the market according to the patient’s economical standards. Even implants systems able to manage the treatment time simultaneously with cost. As it’s a surgical procedure and can be performed for replacement of single tooth or the whole edentulous arch there are protocols which needs to be followed. Various categories and criteria’s-based evaluation decides the implant placement strategies. It’s a specialty practice but now a day’s even general dentists are successfully placing implants. Keeping all this in mind this review is put forward about loading protocols in the implant dentistry which will be helpful for Implantologist throughout the world.

Essential thrombocythemia (ET) and chronic lymphocytic leukemia (CLL) are 2 distinct, clonal hematologic malignancies. The association of ET and CLL is very rare, and only a handful of cases have been described in the literature, the pathogenic mechanisms of this phenomenon remain unclear. Here we describe a patient with an uncommon case of Janus Kinase 2 (JAK2) V617F positive ET treated by hydroxyurea and pipobroman, who eventually developed a second unrelated hematologic malignancy, CLL

Medicinal plants have been used in virtually all cultures as a source of medicine. Asthishanharak (pacification of bones) [Cissus quadrangularis Linn.] belonging to Family Vitaceae is also popularly known as hadjod (bone setter) in Hindi. It is a perennial climber widely used in Ayurveda, for Pachana (digestive aid), Sara (relieves constipation), Athiyuk (strengthening bones), Vrishya (Aphrodisiac), Krumighna (destroys worms), Arshoghna (cures piles), Balya (provides strength), Amaghna (Relieves ama – a product of indigestion and altered metabolism), Kushthaghna (cures skin disorders) activities. It possesses calcium oxalate, β-carotene, ascorbic acid, β-sitosterol and 3-ketosteroids, also flavonoids like quercetin, and kaempferol. The stem has two unsymmetrical tetracyclic triterpenoids, onocer-7-ene-3α, 21β-diol and onocer- 7-ene-3β, 21 α –diol, two steroidal principles I and II, δ-amyrin, δ-amyrone. It has been reported to have bone fracture healing, Antioxidant, Free radical scavenging, Anti-microbial, Anti-fungal, Anti-bacterial activity, Anti-fungal, Anti- viral activity, Anti-ulcer activity, Analgesic, anti-inflammatory and stimulatory activity, Anti-obesity activity, Anti-pyretic activity, Anti-haemorrhoidal activity, Anti-tumour and cytotoxic activity, Anti-helminthic activity and Gastro-protective activities etc. Considering its therapeutic values, a review has been done to compile information on Ayurvedic aspect of Asthisanharak. Moreover Ayurvedic references, the present paper also emphasizes on its pharmacognostical studies, phytochemical constituents and researches conducted on this plant for its clinical and pharmacological evaluation which would be worthwhile to explore its unique features.