We report the case of a girl of 2 years and a half, without a notion of consanguinity, admitted for erythema of both cheeks which appeared 40 days after birth. In view of the notion of photosensitivity and the appearance of poikiloderma found in the clinical examination, the diagnosis of Rothmund Thomson syndrome was retained. Rothmund Thomson syndrome is a rare genetic disorder with autosomal recessive inheritance. It is characterized by the early onset of poikiloderma associated with various cutaneous and extra-cutaneous abnormalities with an abnormally high incidence of cutaneous cancers. There is no treatment of the disease, the care is limited to its consequences

Background: Health care employees need stress reduction and burnout prevention more than ever thought. Aim of study: to evaluate the effect of an intervention program on job stressors and burnout among preretirement employees in Health Insurance Hospital at 10th of Ramadan city. Subjects and Methods: The study was carried out in the Health Insurance Hospital at 10th of Ramadan city using a quasi-experimental design with pre-post assessment on a convenience sample of 100 preretirement employees. A self-administered questionnaire was used in data collection with scales for assessment of job stress and strain, and burnout. The fieldwork was achieved from July to December 2017. Results: Participants were mostly females (67%), at 50-year age (45%). The highest job stressor was the clinic-related one (73%). In total, 63% had high stressors at pre-intervention phase, compared to 29% and 36% at post-and follow-up phases respectively (p<0.001). Also, 36% had high strains before the intervention, which significantly dropped to 20% after the intervention, and to 13% at follow-up. Overall, 29% had high burnout before the intervention, which significantly declined to 9% at postintervention phase, but increased again to 36% at follow-up phase. In multivariate analysis, the intervention was the main significant independent negative predictor of employees’ stress and strain scores, while the stress score was a significant positive predictor of the total burnout score. Conclusion and Recommendations: The intervention program is effective in reducing the levels of stress, strain, and burnout. It is recommended to implement it in the study settings and in similar ones, with improvements of its burnout aspects.

Objectives: This study was undertaken to compare the urine protein to creatinine ratio with 24-hour urine protein estimation in pregnancy complicated by hypertension and to establish the cut-off value of the urine protein to creatinine ratio for predicting significant 24-hour proteinuria. Design: This is a comparative study and consists of a single group of 240 subjects. Setting: This study was conducted in the Department of Obstetrics and Gynecology in collaboration with the Department of Biochemistry, JIPMER, Pondicherry, India, from February 2011 to January 2013. Population: The subjects included 240 pregnant women admitted after 20 weeks of gestation to the JIPMER hospital with hypertension (≥140/90 mmHg). Patients with known cases of renal diseases, diabetes and urinary tract infection were excluded. Methods: A first voided morning sample was obtained for urine protein and creatinine estimation and urine culture. Subsequent urine samples were collected for the 24-hour urine protein estimation. Main outcome measures: The spot urine protein to creatinine ratio and 24-hour urine protein were significantly correlated (r=0.98; P<0.0001). The cut-off value for the protein to creatinine ratio as an indicator of protein excretion ≥300 mg/day was 0.285. The sensitivity and specificity were 100% and 99.02%, respectively. The positive and negative predictive values were 100% and 99%, respectively. Results: The cut-off value for the protein to creatinine ratio as an indicator of protein excretion ≥300 mg/day was 0.285 with significant correlation. Conclusion: The spot urine protein to creatinine ratio is valuable for clinical purposes.

Aim & Objectives: To evaluate main renal artery dimensions. The main renal artery (MRA) diameter provide indirect evidence of accessory renal arteries (ARA). Materials and Methods: 60 well embalmed cadavers from the Department of Anatomy, Stanley Medical College were included in this study. Dissection is through Conventional Dissection Method. Results: Of the 60 cadavers 72% had Mean Renal Artery diameter of more than 4mm. 28% had less than 4mm. But in each of the 28% of cadavers the kidneys were supplied with an accessory renal artery arising directly from the abdominal aorta. Conclusion: Multiple renal vascular variations are present in screening of normal patients and a sound knowledge of possible variations is very useful for radiologists, urologists and surgeons in general which prompted us to undertake this study.

The need for the use of two or more languages as media of instruction in high schools in Africa cannot be over-emphasised in the education sector. This is because the present knowledge society demands the use of different teaching and learning methods in achieving the educational potentials of students. Based on this therefore, multilingual education is the key for cultural reasoning, which enables students to decipher concepts easily and meet their goals in life. This study focused on multilingual education as a pedagogical approach in improving learners’ learning outcomes. It had two main objectives: to explore the benefits of multilingual education, and to examine the challenges inherent in multilingual education in culturally diverse high schools in two Cities of Kenya and Nigeria. The study adopted mixed methods research paradigm, specifically, the convergent parallel triangulation design. It targeted teachers and students. The sample size of the study consisted of 40 teachers and 100 students. The study employed simple random and purposeful sampling techniques in selecting the schools and participants of the study. The researchers used interview guide and questionnaire for data collection. For data analysis, the researchers transcribed the interviews, coded the data, categorised the data, derived themes from the categories, interrelated the themes, and interpreted the meaning of the themes; then related them to the quantitative data. For the quantitative data, they focused on the descriptive statistics. The Findings of the study showed that multilingual education, which is the use of multiple languages in the process of teaching and learning for easy comprehension of concepts is beneficial to the education sector. Therefore, it should be encouraged and promoted. However, that teacher factor is the main challenge that the phenomenon is faced with. The study then recommended that in-service training of teachers and proper monitoring of the education policy on the application of multilingual education should be strictly adhered to

This study, using descriptive survey design, investigated basic computer word processing competencies and level of attainment of secondary school science teachers in Delta State Capital Territory, Nigeria. The population of the study was 150 (90 male and 60 female; 110 urban and 40 rural) science teachers from 15 secondary schools in Delta State Capital territory. The sample of the study was 135 (84 male and 51 female; 104 urban and 31 rural) science teachers. Five research questions were posted. A validated and reliable instrument, computer word processing competency attainment level, was used to collect data. Mean statistic, was used to analyze the data. The results revealed that secondary school science teachers in Delta State Capital Territory, irrespective of school location and gender, have high basic computer word processing competency level. Recommendations were given to encourage sustainable high manpower training of science teachers, in basic computer word processing.

Background: Incidence of younger age Acute Myocardial Infarction (AMI) is increasing worldwide. This study was aimed to ascertain plasma PAI-1 as an independent biomarker in STEMI, Quantification and Establishing the indicative evidence range of Plasma PAI-1 and ascertaining it’s correlation with CK-MB in young south Indian ethnics. Methodology: This cross sectional study was conducted at MGMGH, Tiruchirapalli. Study subjects includes 40 Patients with typical chest pain, shows ST Elevation in ECG, rise in CK-MB and without any other risk factors of AMI. 40 age and sex matched control subjects were studied at the same time. Plasma PAI-1 (ELISA KIT-KOCH 3071) was assayed within six months of sample collection. Analysis of Serum Urea, Creatinine, Glucose, Lipid Profile, CK-MB and others risk factors of AMI was done on admission. Statistics was analyzed using SPSS -19.0. Results: There was a positive significance association observed in plasma PAI-1 (P ≤ 0.001), Serum Urea: P ≤ 0.001, Serum Glucose: P ≤ 0.04, Serum AST: P ≤ 0.001, Serum CK-MB: P ≤ 0. 001 and Serum HDL: P ≤ 0.008 between patients and control subjects. The Mean and SD of plasma PAI-1 for patients and Controls are 3450.76 ± 1406.68 and 1966.03 ± 1406.68. Furthermore an inverse association observed between plasma PAI-1 and HDL level. Conclusion: This study statistically confirmed the independent association between STEMI and plasma PAI-1 and established its analytical range as 3000-5000 pg/ml, wherein, it is 1000- 2000 pg/ml for controls also observed the inverse association of Plasma PAI-1 with serum HDL levels.

Chronic hyperglycemia is one certain cause of diabetic retinopathy. VEP findings may identify pathology in both early and late stage diabetes. Present study was done to evaluate the effect of acute rise in blood sugar on visual evoked potential in normal subjects. Subjects aged between 17yrs -21yrs of both sexes (n=100) were selected for the study. First recording of VEP done then measurement of capillary blood glucose level done prior to administration of 50 Gm Glucose then repeat measurement done after ½ hour. After rise of capillary blood glucose level recording of VEP was done. Latency of N75 and P100 along with amplitude of N75-P100 has been analysed. Amplitude of N75-P100 has statistical significant difference with p-Value of 0.0054 for right eye and 0.0039 for left eye. Sudden rise of blood sugar level certainly affects result of VEP even in non-diabetic persons. To avoid wrong interpretation of VEP findings every physiologist should consider this post-prandial effect of increased blood sugar while doing VEP in diabetic as well as non-diabetic.

In a recent article Morton et al. reported about a new-born female with mitochondrial disorder(MID) due to a mutation in the AIFM1 gene on chromosome Xq26.1 encoding for a mitochondrial matrix protein with oxidoreductase activity involved in electron transport, apoptosis, ferredoxin metabolism, reactive oxygen species generation, and immune system regulation. The patient obviously manifested also in the lungs with follicular bronchiolitis and hypertrophic walls of pulmonary arteries. Overall, this interesting report could be enriched by genetic investigation of the aunt with multiple sclerosis, a more detailed description of the nerve conduction and electromyographic studies, revision of the cerebral MRIs, prospective investigations of clinically unaffected organs, and by excluding autonomic neuropathy

Background: The word “wound” is as old as man’s creation. Wound can be defined as an injury to the body in which the skin, tissue or organ is broken by some external force such as a blow or surgical incision, with damage to the underlying tissue. AIM: This study was aimed at evaluating Wound Morphometry with respect to wound size and rate of wound contraction using tomatoe seed. Materials and Methods: The Solanum lycopersicum seeds were prepared using 28.0g of blended S. lycopersicum seeds after drying. 24 male wistar rats separated into two groups; experimental and control (of 12 each) was used in this research. A wound size of 2cm by 2cm which exposed the panniculus adiposus was inflicted on the right dorso-lateral shaved aspect of the thorax after anaesthetizing. The wound sizes were immediately measured using a 4cm by 4cm template of transparent sheet and placed on a graph sheet for counting of the small blocks. The experimental group were administered the seed extract while control group was merely dressed without seed extract. Results and Disccusion: The rats treated with L. esculentum (experimental) had a mean wound healing (closure) day of 15.75 ± 1.49 while those treated without seed extract had a mean wound healing (closure) day of 19.50 ± 1.73. Conclusion: The seed of Cherry tomato (Lycopersicon Esculentum) was concluded to have accelerating contracting/ healing (closure) effect with respect to the statistical significant mean value on wound healing (closure) day.

By Universal adoption of first and second trimester screening, the rate of detection of congenital anomalies has been improved with sensitives ranging up to 85-90%, but their detection at an advanced gestational age becomes a dilemma for the patient as well as the obstetrician. With this article we share our experience, dilemma and doubts about some of these rare surgically correctable anomalies managed at our institute

Wilms’ tumor is the commonest renal tumor occurring in 1:10000 children worldwide. One of the important determinants of outcome in childrens are Histopathological features it helps in assessing prognosis and treatment. It is a retrospective study 60 children found to have wilms’ tumor. In our study all cases showed favourable histology 100%, triphasic pattern was seen in 43.3% and monophasic pattern accounted for 56.6% of which the epithelial predominance was seen in 38%, blastemal in 44% and FWRT in 18% which is helpful in assessing outcome of children with wilms’ tumor.

Introduction: Urbanization is associated with higher prevalence of cardiovascular disease worldwide. Aortic stiffness, as measured by pulse wave velocity (Pwv) is a validated predictor of cardiovascular disease. However, in India, there are few population-based studies regarding pulse wave velocity and augmentation index (Aix). Method: Our aim is to determine vascular ageing measured by pulse wave velocity and the arterial augmentation index in urban population. Pulse wave velocity and augmentation index and was measured in 292 urban population subjects without any ECG changes. Results: Normal PWV and the 95% confidence intervals values were obtained in 20-29 year age group (compared to 30–39, 40–49, and 50–60 age groups. The mean Pwv found was 5.85 m/s ± 1.25 (range: 4.86–8.47). PWV increases linearly with aging with a high degree of correlation; with low dispersion in younger subjects. Pwv progressively increases 6–8% with each decade of life; this tendency is more pronounced after 40 years. A significant increase of Pwv between hypertensive versus nonhypertensive, diabetes vs non-diabetes groups were demonstrated. This is the first population-based study from urban population of Nellore that provides normal values of the Pwv in these region. Augmentation index was also increased significantly in both diabetic and hypertensive groups. Conclusion: The findings of present study suggest that, although related, peripheral augmentation index AIx and Pwv provide early identification of high risk groups. Implication of life style modification is the first intervention to consider in adults followed by drug therapy to control risk factors. Specifically, AIx might provide a more sensitive marker of arterial aging in younger individuals

Citizenship education essentially prepares students as citizens as well as good citizens. The learning process must be understood as part of the process of civilizing students so that it becomes a cultured and ethical human person. Thus the development of morality in the learning process is expected to be carried out through the planting of values in students so that they have attitudes and behavior in accordance with the ethics that apply in society. This study aims: (1) To find out data on morality development of students through citizenship education, (2) To determine the contribution of morality guidance through civic education to student ethics, and (3) To determine whether there is influence in morality education through ethics education students. This research uses descriptive quantitative approach method, which was carried out at North Gunungsitoli Junior High School Student. The population is a total of 38 students in class VIII. The entire population is at the same time determined as the research sample (total sampling). To get the data, a questionnaire instrument was used, both for morality development and student ethics. Moral guidance through citizenship education is still classified as not so too student ethics are classified as poor with an average questionnaire value of 57.84. The contribution of morality guidance through citizenship education to student ethics is 73.27%. There is the influence of morality coaching through citizenship education on student ethics, this is based on hypothesis testing using the t-test results obtained t-value = 9.935 greater than t-table = 1.689 In line with the findings of this study, researchers provide several suggestions, among others (1) Teachers should be in the learning process citizenship education provides exemplary and moral guidance to students. (2) Citizenship education subject teachers should develop students' awareness to uphold the ethics that apply in society. (3) Teachers should not make punishment as the only tool to provide guidance to students.

Background: During pregnancy, thyroid dysfunction has been associated with a number of adverse outcomes. The presence of anti- Thyroid Peroxidase Antibody (anti-TPO) also results in post-partum complications. Hypothyroidism is closely associated with the presence of anti-TPO. The study aimed to evaluate anti-TPO and thyroid function tests in first trimester of pregnancy. Materials and Methods: The study was carried out at Department of Biochemistry, Medical College and SSG Hospital, Vadodara, Gujarat, India over a period of one year after prior approval from institutional ethics committee. Total 200 normal pregnant women in their first trimester were randomly selected after informed written consent. Women having known thyroid dysfunction, other endocrinopathies, undergone thyroid surgery or taking thyroid medications were excluded. Overnight fasting blood samples from participants were analyzed for anti-TPO, thyroid stimulating hormone (TSH), total T3 and total T4. Results: Mean maternal age was 25.56 ± 3.32 years. Out of 200, total 30 (15%) pregnant women of first trimester had TSH level >2.5 mIU/l. Out of these 30 females, 9 (4.5%) had overt hypothyroidism & 21 (10.5%) had subclinical hypothyroidism. Among these 30 hypothyroid women, 26 (13%) had found anti-TPO positive (anti-TPO >35 IU//ml) which also showed a significant positive correlation with TSH level and negative correlation with T3 and T4 level. Conclusion: Hypothyroidism especially sub-clinical hypothyroidism is prevalent among pregnant women with positive correlation with anti-TPO. It is suggested that anti-TPO should be added as a screening test in first trimester of pregnancy which can be useful to identify early thyroid dysfunction