It is believed that Michel Foucault‟s Madness and Civilization explores the history of madness and the relationship between reason and unreason. In his book, the unreason or madness can‟t be defined clearly. He thinks people have different cognitions and attitudes to madness in different periods of civilization. The relationship between reason and unreason changes over time. They are not opposed at the beginning instead they impact each other in life and work. In English novels, there are many descriptions of madwomen. Jean Rhys‟ Wide Sargasso Sea is the prelude of Charlotte Bronte‟s Jean Eyre. “The mad woman in the attic” in Jane Eyre is Antoinette in Wide Sargasso Sea. There are many reasons for the madness of Antoinette. What caused her madness can be interpreted well with Foucault‟s madness theory. This paper tries to prove that Antoinette‟s madness is the tragedy of racialism and colonialism and give suggestions to the construction of unreason in the human civilization.

Anabolic Androgenic Steroids (AAS) are being used widely by athletes and gym attendees to augment their physical appearance and enhance performance. The abuse of AAS has serious and irreversible health risks. Objective: To estimate the prevalence of AAS use, assess the knowledge, attitude, practice and describe the associated factors of AAS use to improve the general health of adult male fitness centres attendees. Design: Cross Sectional Study. Setting: Fitness centres in Bahrain. Method: A total of 235 fitness centres were obtained and only 94 fitness centres met the inclusion criteria. Adult males aged 18-65 years old who attended fitness centres during October 2017 were targeted. Self-administered questionnaires were distributed among 20 randomly selected fitness centres covering the 4 governorates. Result: Four hundred forty six males were included. The prevalence of AAS use was 14.6%, the highest result was 26.4% found in Muharraq governorate. The majority of AAS users were Bahrainis (17.8%) and aged 30–39 years old (17.9%). Both AAS users and non-users had low knowledge score. Regarding the harmful effects of AAS, 18% of AAS users thought AAS use is bad for health. The most common route of AAS use was the combination of injectable and oral route (63.5%). Significant association was found between AAS use and the use of other supplements such as growth hormones, proteins and amino acid, smoking and energy drink consumption (P=0.05)

A 3 year old Nigerian local breed dog weighing 15kg was presented with signs of lacrimation, drooling salivation and weakness. The owner gave diazintol® bath to the dog and later observed the dog salivating. Clinical evaluation showed temperature, pulse and respiratory rates of 39.7oC, 99 beats/min and 62 cycles/min respectively. Haematological analysis showed PCV of 38% and the case was managed as a case of organophosphate poisoning

Oxyuriasis is an intestinal parasitosis, frequent, strictly human, caused by a cosmopolitan roundworm: Enterobius vermicularis. Pinworms are mainly localized in intestine but can sometimes be found in the female genitalia, even if it is rare. Our case is a young man of 32 who has an anterior history of inconstant anal pruritus but and who presented a pruriginous and painless subcutaneous nodule and who benefited from an excisional biopsy whose pathological examination revealed the presence of sections of nematodes corresponding to female pinworms within a fibro-fatty tissue. Oxyuriasis is mainly intestinal, sometimes with an uro-genital location, especially in women, but no case has been described at the subcutaneous level, hence the interest of this work in revealing new possible locations of this parasitosis

A simple and precise reversed-phase high performance liquid chromatography (HPLC) assay for the determination of rifampicin (RIF) in human plasma was developed and validated. Using hydrochlorothiazide (HCT) as an internal standard, separation was achieved on Atlantis dC18 column with a mobile phase composed of 0.01 M monobasic sodium phosphate and acetonitrile (60:40, v:v) and delivered at a flow rate of 1 ml/minute. RIF and HCT were extracted from plasma using methyl tert-butyl ether and dichloromethane (70:30%, v:v) and monitored using photodiode array detector set at 337 nm. Relationship between RIF concentration and peak height ratio of RIF to HCT was linear over the range of 0.3-25 μg/ml. Coefficient of variation and bias were ≤9.7% and ≤6.0%, respectively. Mean extraction recovery of RIF and HCT was 95% and 90%, respectively. Stability of RIF in extracted (24 hours at room temperature or 48 hours at -20 °C) and unprocessed (24 hours at room temperature, 8 weeks at -20 °C, or 3 freeze-thaw cycles) samples was ≥91%.

Aims: The present study aimed to investigate the local anesthetic activity of Chrysanthemum cinerarifolium extract as well as to formulate a topical local anesthetic gel containing the extract to be used for human. Methods: The local anesthetic activity was assessed using the intradermal wheal method in eighteen guinea pigs divided into three groups, six in each group. Pain response was elicited by gentle pinprick. Two concentrations (1.0 and 0.3mg/ml) of lidocaine were injected intradermally into the left and right dorsal flank of the animal respectively to form wheals, which were encircled with a marker. Similarly, two concentrations (100 and 50mg/ml) of the plant extract were injected into the left and right dorsal flank respectively of another group. Normal saline was injected into the control group. The encircled areas were each pricked with a pin 6 times at 5 minutes interval for 30 minutes starting with zero-time before the injection. To confirm the animal study, prepared gels of the plant extract (1%) and lidocaine (1%) were applied on two groups each containing 6 human volunteers, and the local anesthetic activity was assessed. Results: The plant extracts exhibited a local anesthetic activity on guinea pigs. Comparable results were also observed of the local anesthetic activities of both topical gels prepared from the plant extract or lidocaine in human. No adverse effects were observed either in animals or in human. Conclusions: Chrysanthemum cinerarifolium extract possesses a local anesthetic activity in both animals and human

Introduction: Breastfeeding is a natural act and an unequalled way of providing ideal food for the healthy growth and development of infants, it is also an integral part of the reproductive process with important implications for the health of mother. Objectives: To assess the knowledge, attitude, practice of exclusive breastfeeding among the married women in Mangalore. Methodology: A cross sectional study was conducted in rural areas of Mangalore for a period of one week. In among 110 randomly selected married women to assess the Knowledge, Attitude and Practice towards breastfeeding. Results: In our study, 68 (61.8%) belongs to the age group of 20 to 40 years. Of the 110, 90% knew about the importance of colostrums but only 37.3% knew that it helps mothers to lose weight after pregnancy. Around 75.5% were aware that breast feeding can help preventing diseases affecting breast and only 47.3 % knew about its contraceptive advantage. Most of them, 60 (54.54%) women disagreed with the fact that formula-feeding is more convenient than breastfeeding, 45 (40.91%) were of opinion that formula-fed babies are more likely to gain weight more quickly and 40 (36.36%) felt formula feeding is better choice for working women. Among the study participants, only 50.9% of the participants initiated breast feeding within half an hour and only 20(22.47%) women who were home makers exclusively breastfed their babies. 44.5% and 34.5% supplemented newborn with formula to improve babies health and because breast milk was insufficient respectively and it was seen more (79.35%) among women who were literates. Conclusion: The study concludes that even though women have good knowledge and almost all have positive attitude towards exclusive breastfeeding, still not all of them are practicing exclusive breast feeding and many still supplement newborns with formula feeding even though not recommended

Cholesterol and triglyceride fats are transported as part of lipoprotein particles in the bloodstream. The various lipoprotein classes Low Density Lipoprotein (LDL) that carry most part of the blood cholesterol, Very Low Density Lipoprotein (VLDL), which carry most of the blood triglycerides, High Density Lipoprotein (HDL) and Chylomicrons. LDL also found as serum cholesterol plays a significant role in coronary heart diseases. The role of these lipoproteins is quite independent of other risk factors and is quite predictive that could be easily assessed. The present article is focused on the estimation of plasma lipoprotein (a) [Lp(a)] level in AMI patients along with their cardiac Troponin-I levels to study the correlation between the two and to look into the possibility of dual marker approach to deal with complications associated with acute myocardial infarction. Lp(a) is a major risk factor of several cardiovascular diseases, namely atherosclerotic vascular diseases, aortic calcification, and perhaps also venous thromboembolic diseases and hence could be a prominent therapeutic target for primary and secondary prevention. This calls for the development of a safe and effective means of lowering Lp(a) that will provide an opportunity to conduct intervention trials to further decipher its contribution in the etiology of CHD

Healthy and strong body function was essential in the job of prison management, and smoking had been proved to induce negative impacts. Based on the health belief model, the current research explored the association among health belief on smoke -cessation, self-efficacy on ceasing smoke, and possibility of ceasing smoke among the prison officials. Samples were 182 officials recruited by snowball sampling method, 72.53% were male. Test results indicated the barrier to ceasing smoke had a lowest average 2.95(±1.04), followed by benefit of ceasing smoke (3.49±0.54), perceived susceptibility (3.51±0.75), perceived severity (3.59± 0.78), self-efficacy (3.65±0.77), and possibility of ceasing smoke (3.67 ± 0.99). As to the variance analysis, history of smoking and residence were two major variables that made the constructs different, whereas age and marriage contributed the least. Noteworthy was that the education is the major contributor to the difference of smoke-ceasing possibility among respondents. Results from regression analyses indicated that perceived benefits (β=.52) and perceived barriers (β=.23) were the two major predictors of smoke-ceasing, and the other independent variables (IV) were not significant in this model (adj. R2=.279). The variance explained increased to 48.3% (adj. R2=.483) in the model with additional variable of self-efficacy. Perceived benefits and perceived barriers were replaced by the self-efficacy, and made all original IVs not significant. This indicated the mediating effects of self-efficacy between predictors and smoke-ceasing. The current research suggested the judicial correction institute shall logically staff required officials for the jobs of prison management, and recommend several smoke-ceasing measures.

Non traumatic liver rupture is an extremely rare condition; it most often complicates HELLP syndrome and rarely some liver diseases. We are reporting a case of 26-year-old man followed for behcet’s disease, presented to the emergency hemodynamically instable on a large hemoperitoneum due to a spontaneous liver rupture. We believe that intrahepatic hematoma was caused by a rupture of a segmental right liver artery aneurysm and then spontaneous rupture of the intrahepatic hematoma occurred leading to liver rupture. The surgical management consisted on perihepatic packing and two months later a medical management of sub infected liquefied residual liver hematoma

Brown tumors are benign osteolytic bone lesions, they are rare, caused by the disorder of the phosphocalcic metabolism that typically complicate primary hyperparathyroidism (PPHT) in 4.5% and secondary hyperparathyroidism (HPTS) in 1.5 to 1.7%. Brown tumors are located mainly in the ribs, the pelvis, femurs and mandibles. Spinal locations are very rare, they especially affect the thoracic region. Very few cases of cervical brown tumors have been reported in the literature. To date, there have been only 12 cases, the last in 2018 by M. Sánchez-Calderón et al. Reporting the case of a 65-year-old woman treated in our department for cervical C4-C5-C6 brown tumor responsible for spinal compression, revealing primary hyperparathyroidism. We note the interest of the suspicion of a brown tumor in front of any osteolytic vertebral lesion, especially in patients suffred from end stage renal disease, and hypercalcemia. Early diagnosis and setting up a multidisciplinary management prevent complications and functional aftereffect, despite the benign histological characterof her injuries.

Objective: To evaluate the characteristics of central corneal thickness (CCT) in glaucoma patients followed a military hospital in Rabat. Patients and methods: This is a retrospective study of glaucoma patients followed in the military hospital ophthalmology flap service between January and December 2018. All subjects underwent a complete ophthalmic examination that included measures of CCT with an ultrasonic pachymeter. Results: A total of 205 patients (123 men and 82 women) were included in this study corresponding to 410 eyes. The age of patients ranged between 19 and 79 years. The average central corneal thickness was 519.54 ± 27.52µm in the right eye and 520.71 ± 27.99 µm in the left eye. Comparing the CCT between men and women and between the right eye and the left eye the other hand finds no statistically significant difference. Thus, the average age of the patients was 50.74 ± 12.7 years, with a mean central corneal thickness of 520.12 ± 27.75 microns. Discussion and conclusion: Compared to the Caucasian patient, our glaucoma patients differ in the early glaucoma and the thinness of the cornea, and are close to black African patients. This may induce a potential error in the measurement of intraocular pressure in glaucoma patients where our interests of Forever correlate intraocular pressure with pachymetry.

Background: Fine-needle aspiration (FNAC) cytology is well established and widely used to evaluate palpable lesions and, with imaging studies as an adjunct, is equally applicable to deep-seated lesions. Although FNAC is considered quite a reliable procedure for diagnosing salivary gland lesions, one comes across frequent diagnostic challenges in diagnosing salivary gland lesion. Methods: 180 patients were enrolled in the study from January 2014 – august 2016 .Out of these 69 samples had histopathology samples. Special stains (PAS-D) and cell blocks were prepared wherever necessary. Results: Benign neoplastic lesions were (68.1%) found to be the most common with pleomorphic adenoma being predominant of all. Mucoepidermoid carcinoma was the most common malignant lesion followed by adenoid cystic carcinoma. Conclusion: Diagnostic dilemmas are commoner in certain lesions such as basaloid neoplasms, oncocyte lesions, mucus containing cysts and lesions with squamous cells or lymphocytes, spindle cells. These pitfalls can be reduced to minimum by adequate sampling by multiple passes from different areas along with thorough clinical and radiological examination.

A simple, rapid, precise, stability indicating, isocratic reverse phase-high performance liquid chromatography method has been developed and validated for the determination of Zonisamide in bulk and pharmaceutical dosage form. The Chromatographic Separation was achieved by using Enable ODS reverse phase (250 x 4.6 mm, 5 μm particle size) C18G column. Mobile phase consists of mixture of 0.1% (v/v) ortho phosphoric acid and Methanol in the ratio of 30:70 (v/v) and was delivered at a flow rate of 1 ml/min, while the detection was monitored at a wave length of 285 nm. The developed method showed excellent linear response (r2>0.9999) in the range of 10-70 μg/ml. The retention time for Zonisamide was found to be 3.5 mins. The proposed method was validated as per ICH guideline and can be applied for estimation of Zonisamide in pharmaceutical dosage forms in routine analysis.

The aim of the present study was to study the efficacy and safety of Nebivolol and Metoprolol in post-myocardial infarction patient and to compare the efficacy and safety of Nebivolol and Metoprolol in post-myocardial infarction patients. This randomized, open-label and comparative study was done in the Department of General Medicine, Kakatiya Medical College, and MGM Hospital Warangal. A total of n=110 patients were selected based on inclusion and exclusion criteria. Patients were randomized to two groups N-groups of n=55, M-group to receive once-daily Nebivolol 5 mg and Metoprolol 50mg twice-daily respectively for 2 months. Clinical laboratory parameters were measured at day (0), and at day 56. Results The standing baseline mean systolic blood pressure 166±9 mmHg was reduced to 139±10 mmHg after 2 months treatment with Nebivolol, whereas in case of Metoprolol standing baseline systolic blood pressure 161±11 mmHg reduced to 143±14 mmHg after 2 months treatment. In case of standing, baseline mean diastolic blood pressure 103±7 mm Hg reduced to 84±4 mmHg after 2 months of treatment with Nebivolol, whereas with Metoprolol standing baseline diastolic blood pressure 100±6 mmHg reduced to 87±7 mmHg after 2 months treatment. Heart rate in case of N-group baseline 87±9 beats/min reduced to 74±6 beats/min after 2 months treatment, whereas in M-group baseline heart rate 82±7 beats/min reduced to 76±5 beats/min after 2 months treatment. Conclusion: it can be concluded that Nebivolol is superior to Metoprolol in control of blood pressure in post-myocardial infarction patients with hypertension. The distinct advantages of Nebivolol include lower incidences of adverse effects and since the dose is single there is better compliance as compared to Metoprolol