Objective: The objective of this study is to compare the apical sealability of mineral trioxide aggregate (MTA) Fillapex and Endosequence BC sealer at three different lengths of remaining gutta-percha after postspace preparation. Materials and Methods: A total of 160 freshly extracted human maxillary anterior teeth were decoronated, biomechanically prepared, and randomly divided into four groups; Group A and Group B served as positive and negative control with 20 teeth each. The teeth in Group C and Group D (with 60 teeth each) were obturated with gutta-percha using MTA Fillapex sealer and Endosequence BC sealer, respectively. Teeth in Group C and Group D were further subdivided into three subgroups depending on the length of remaining apical gutta-percha, i.e., 3, 4, and 5 mm after postspace preparation. Apical leakage was assessed using dye penetration method under stereomicroscope. Results: In both the Groups C and D, there was overall no statistically significant difference in leakage; however, Group C showed slightly more leakage than Group D. There was a statistically significant difference in leakage at 3 mm and 5 mm level in both groups. Conclusion: Although less microleakage occurred, the bioceramic sealers could not totally eliminate leakage.

This study aims to analyze the implementation of the Financial Services Authority's circular letter number 14 / SEOJK.03 / 2017 concerning the health level bank, for Branchless Banking of PT. Bank Rakyat Indonesia Tbk by implementing the RGEC (Risk Profile, Good Corporate Governance, Earning, Capital) method between in 2016 and 2017 banks through a comparative analysis. The purpose of this study is to analyze the performance. The method used in this study is RGEC (Risk Profile, Good Corporate Governance, Earning, Capital), while the long-term objective is modeling the financial strategy assessment of Branchless Banking in Indonesia. The result that there are not differences in financial performance between before and after the implementation of the Financial Services Authority's circular letter number 14 / SEOJK.03 / 2017 concerning the health level bank, for Branchless Banking of PT. Bank Rakyat Indonesia Tbk.

Aim and Objectives: The aim of the study is to evaluate the effect of single visit apexification versus complete obturation with Mineral Trioxide Aggregate and Biodentine on the fractured resistance of simulated immature teeth. Material and Method: Forty five freshly extracted non-carious maxillary central incisors with single canal were selected. The apical 5mm of each tooth was then removed, access cavity preparation followed by preparation using peeso reamers was done to simulate Cvek’s stage 3 of root development. Irrigation protocol was carried out followed by randomization of samples and then canals were obturated using different materials. Fracture testing was done under universal testing machine and the ultimate load to fracture was recorded in Newtons. Statistical Analysis: Statistical analysis was done using SPSS 20.0 Software. One way analysis of variance followed by pair wise comparison of the groups was performed using Tukey’s post hoc test. The level of significance was set at 95% (p < 0.05). Results: All the experimental groups had a statistically higher value of fracture resistance than the control groups. Group I (entire canal obturated with MTA) showed highest value of fracture resistance followed by group III (entire canal obturated with biodentine), group II and group IV. Conclusion: Reinforcing immature teeth with bioactive materials such as MTA and biodentine is advantageous for apexification. Clinical Significance: Full MTA obturation clinically in patients might produce high success rate of apexification as compared to MTA and Biodentine apical plug and gutta percha obturation

Aim and Objective: To compare perinatal outcome of maternal adiposity to normal BMI Women. Material And Method: This is hospital based prospective study .results-a fatty women deliver more Macrosomic baby, need more NICU admission, more birth trauma, more hospital stay, more congenital anomaly baby, low apgar at 5 minite

Interest in felony disenfranchisement is growing rapidly because of the rising rates of felony offenses and disenfranchisement. In fact, an estimated 6 million Americans are denied the right to vote as a result of their felony convictions. Felony disenfranchisement is an obstacle to participation in democratic life- a reality exacerbated by the current racial disparities in the criminal justice system which result in 1 out of every 13 Blacks being unable to vote (Sentencing Project, 2015). As there is little we know about the differences between Black and felony experiences with disenfranchisement, this study focused on everyday disenfranchisement experiences that research suggests Black males face. The focus was on perceived discriminations resulting from entitlement programs (i.e. employment, housing, educational and other forms of government assistance). It was predicted the persons with felonies would have a different perception of disenfranchisement or discrimination, but results indicated both groups perceived similar experiences with discrimination, confirming findings in the extant literature.

This study aims to comparative analyze for financial performance of PT HSBC Indonesia in 2017 and 2018. The method used in this study is paired sample t test. The result are not difference significant between Performance Ratio of Bank HSBC in 2018 and Performance Ratio of Bank HSBC in 2017. Ratio Performance of bank HSCB are had 9 data decreasing are Minimum Capital Requirement (KPMM) problematic productive assets and non-productive assets of total productive assets and non-earning, problematic productive assets against total earning assets, reserve for impairment losses (CKPN) of financial assets to earning assets, gross NPL, Net NPL, Return on Assets (ROA), Return on Equity (ROE) and Net Interest Margin (NIM) , Ratio Performance of bank are had 2 data increasing are Operational Expenses on Operating Income and (BOPO) and Loan to Deposit Ratio LDR but Financial performance of HSBC are not difference significant between Performance Ratio of Bank HSBC in 2018 and Performance Ratio of Bank HSBC in 2017.

Nurses’ awareness of professional rights and values and how those values affect their behavior is an integral part of nursing care. This study aimed to assess the perception of married nurses regarding women’s rights and obligations and also to assess the family support towards nursing services and professional development in selected tertiary hospital of West Bengal. This descriptive survey was conducted with 103 married nurses employed in North Bengal Medical College and Hospital who were selected by non probability, total enumerative sampling technique. Data were collected using investigator prepared rating scale and the responses were self reported by the participants. The data were analyzed by descriptive statistics, associations between socio demographic variables and mean scores were analyzed by inferential statistics like chi square test. The results revealed that 46% of the nurses had average perception about their professional rights but 73% of them had good perception about their personal rights, 62% of the nurses had good perception about their professional obligations related to patient care and only 16% of the nurses had good family support towards nursing services and professional development. It was also evident that age, duration of service and type of family (χ 2 values = 4.133, 7.433, 7.336 respectively) at 0.05 level of significance were associated with perception of women’s rights and obligations. Family support was associated with professional qualification of nurses, monthly family income, type of family and working hours (χ 2 values = 4.307, 6.26, 7.01, 6.448 respectively) at 0.05 level of significance. Further studies using standardized tools and other reliable and culture specific instruments are recommended.

Background: In the past three decades, health reform has become commonplace in most countries. Such that reforms decentralized governance of health systems has been adopted in some countries as a subset of broader health reforms or as a preferred management strategy. This review was performed to synthesize evidence around this issue. Specifically, the objective was to answer the question: “What is the role of devolution in service delivery, health workforce and medical commodities acquisition?”. Methods: CrossRef, Google Scholar, Academic keys, Open Academic journals index, MEDLINE, Embase, CINAHL, and PsycINFO were searched with terms related to devolution and health. The search included terms related to service delivery, health workforce and medical commodities. Findings were presented within a narrative synthesis. Quality of the evidence was evaluated using the Cochrane risk of bias tool and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Findings: A few studies, all cross-sectional studies, met the selection criteria for this review. Most studies noted the major benefits resulting from devolution in terms of local governance and citizen participation in the health service delivery sector. The UK and India are some of the countries with evidence of how devolution impacts positively from accountability and participation. Some of benefits reaped include developed leadership, effective monitoring, promotion of quick delegation of work and generation of interest among employees. In Kenya, health sector still undergoes significant human resource deficiency, in spite of the government investing over the years from independent and also considering the devolution of health services. Healthcare workers shortage affects how health institutions functions. Studies showed that health workers positively respond to the demands of human resource of a decentralized unit if they look for employment in it, if a post is offered, they accept, and stays in service. Their ability and willingness to act in response to local demands are due to a number of factors. However, there is little literature on the best level of the government in provision of public type medical services. The recent focus has been entirely on the merits of local provision. Local governments are more responsive to their citizens compared to the central government. Conclusions: A universal objective of health systems should be to reduce inequality in health and promote equity, but the impact of Devolution of health system governance on equity has been questioned.

Background: Worldwide health systems are facing an increasing number of challenges, while governments remain dedicated to searching for cost-effective options to enhance the capacity of national health systems to perform well. Although the relationship between devolution and disparities in access to health care is mixed, most studies do not attribute observed disparities in healthcare use to Devolution. This review was performed to synthesize evidence around this issue. Specifically, the objective was to answer the question: “What are the contribution of devolution in health financing, health leadership, and health information systems?”. Methods: CrossRef, Google Scholar, Academic keys, Open Academic journals index, MEDLINE, Embase, CINAHL, and PsycINFO were searched with terms related to devolution and health. The search included terms related to health financing, health information systems, and health leadership. Findings were presented within a narrative synthesis. Quality of the evidence was evaluated using the Cochrane risk of bias tool and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Findings: A few studies, all cross-sectional studies, met the selection criteria for this review. Most studies noted the Healthcare is a major element of national budgets worldwide in as much as all levels vary across countries, systems have come under increased pressure to ensure that resources are spent efficiently.

Perinatal asphyxia leading to Hypoxic Ischemic Encephalopathy (HIE) is a major concern in newborn morbidity and mortality in India. In this study we have done transcranial USG and MRI brain of both term and preterm newborns to detect the HIE related changes in neonatal brain and also evaluated wheather MRI is better than USG in detecting the lesions.This cross sectional analytical study was conducted at Calcutta National Medical College and Hospital, Kolkata with 57 newborns (26 preterm,31 term) for a period of one year. Cranial USG was done on day 5 to day 7 of the baby and MRI brain of the same baby after 24 hrs of doing USG. We found that cerebral oedema, lesions of basal Ganglia, thalamus and parasagittal subcortical white matter injury were more common in term babies, whereas Germinal Matrix Haemorrage (GMH), IntraVentricular Haemorrage (IVH) and PeriVentricular Leucomalacia (PVL) were common in preterms.When we compared USG and MRI findings we found statistically significant difference in relation to detection of abnormal findings(49 by MRI,33 by USG},deep grey matter insult of basal ganglia, thalamus (22 by MRI, 8 by USG), parasagittal subcortical white matter injury (6 by MRI,0 by USG) with p value less than 0.05.Detection of GMH and IVH was 15 by MRI and 9 by USG. In conclusion, though USG is a less expensive initial screening tool in detecting HIE related lesions and it can detect IVH, GMH very effectively, but MRI brain should be the final investigation of choice to detect both central and peripheral cortical injuries in newborn with perinatal asphyxia.

Communication climate influences quality of work environment as it contributes to the effectiveness and success of an organization. Organizations with positive communication climate have good employee relationships that in turn improve staff empowerment and career growth. Aim: The current study aims to determine the impact of communication climate on nurses’ organizational career growth and empowerment. Research design: Quasi-experimental research design has been carried out. Setting: The study conducted in (General medical and surgical departments) at Qena and Sohag University Hospitals. Sample: All available nurses working in the designated sites 98. Tools: three tools were used, communication climate questionnaire, organizational career growth scale, and conditions of work effectiveness questionnaire II. Results: The present study findings that there were highly statistical significance differences of communication climate, organizational career growth, and structural empowerment between the two hospitals X2 = 16.843, 18.18 and 30.247 respectively & P<0.01. Regarding means and standard deviations it was 54.20±9.35 & 41.39±13.47 for communication climate, 47.02±8.60 & 37.69±10.05 for organizational career growth, and 55.20±9.39 & 41.04±11.60 for structural empowerment at Qena and Sohag University Hospitals respectively. Conclusion: The improvement in the communication climate results in higher levels of organizational career growth and structural empowerment. Recommendations: Management should develop and maintain communication climate that enables free expression of ideas and exchange of opinions among staff. Managers should encourage nurses’ empowerment for effective organizational performance. Nurses’ organizational career growth and continuing education are important for improving staff performance and skills.

Retinal nerve fiber layer thickness (RNFLT) is affected in several ocular and systemic conditions, most commonly glaucoma and diabetic retinopathy. This cross sectional study was done to compare the RNFLT in 180 eyes of 90 patients. A total of 90 patients were assigned to 3 groups of 30 patients each of primary open angle glaucoma (POAG), type 2 diabetes mellitus (T2DM) and POAG with T2DM (POAG/T2DM). The RNFLT was measured with spectral-domain OCT. Readings from all the areas of retina were measured in both eyes. Presence of T2DM in patients of POAG significantly affected the RNFLT as compared to patients of POAG or T2DM individually. The RNFLT was negatively correlated with the duration of glaucoma, duration of diabetes and HBA1c levels. Hence, care should be taken in interpreting optical coherence tomography readings in patients of POAG/T2 DM. The changes in RNFLT can be used to monitor the progression of diseases affecting RNFLT and efficacy of treatment modalities.

Background: Auditory reaction time (ART) and visual reaction time (VRT) are non-invasive techniques used to assess the capability of the CNS to integrate sensory and motor activities based on the level of CNS arousal and alertness. There is a lacuna for studying the impact of nicotine in smokeless tobacco users, therefore this study aimed to estimate and compare ART and VRT of smokers and dipping tobacco users with non-tobacco users in different age groups. Methods: Total 612 apparently healthy male subjects were divided equally on the basis of habit into three groups namely smokers, dipping tobacco users and control (non- tobacco user) with 204 subjects in each group. They were divided further on the basis of age into 4 sub groups like 11-20 years, 21-30 years, 31-40 years and 41-50 years with having 51 subjects in each group. RTM-608 (Medicaid system) apparatus was used to measure audio-visual reaction time under strict precautions and standard protocols to minimize the effect of other variables on reaction times. Data was analyzed using one way analysis of variance in each group. Results: All age groups differ significantly from each other for ART and VRT (ANOVA; p<0.05). Significant reduction was found for ART & VRT for dipping tobacco users as compared to control and smokers (p <0.05). ART and VRT increases with age in each group of control, smokers and dipping tobacco users. Conclusion: The audio and visual reaction time was significantly higher in older individuals. Reduction in ART and VRT were observed in the dipping tobacco users and smoker which shows acceleration of the response to stimulus

This study was carried out in 388 premature babies for incidence of retinopathy of prematurity, foetal and maternal risk factors to design an effective screening program for ROP. Further, the efficacy of mode of treatment was evaluated. Preterm neonates with birth weight ≤ 1500 grams and/or gestation age ≤ 32 weeks; and selected patients with birth weight between 1500 to 2000 grams or gestational age > 32 weeks but ≤ 35 weeks with unstable clinical course were included in the study. The incidence of any stage of ROP in this study was 23.70%. Majority of patients (88.64%) developed mild forms of ROP (stage 1 and 2). On univariate analysis, the significant risk factors predisposing to ROP were low gestation age, low birth weight, respiratory distress, unmonitored oxygen supplementation, sepsis, blood transfusion, surfactant use and metabolic acidosis. Significant maternal risk factor was pregnancy-induced hypertension. On multivariate logistic regression, low gestational age, unmonitored oxygen supplementation, use of surfactant and pregnancy induced hypertension were found to be independent risk factors. The majority of cases (70.65%) of ROP of stage 1 and 2 without plus disease regressed without any treatment. Rest 29.35% cases needed treatment, and were treated with Diode laser photocoagulation to avascular retina. Regression occurred in all the cases.

Introduction: Breast cancer is the furthermost typically identified life-threatening most cancers in female and the foremost motive of most cancers loss of life among women. Aims and Objectives: Due to the absence of information involving breast cancer in Jouf region, KSA. Our study was directed to discover out the level of their knowledge about breast cancer and practice of breast self-examination amid the study population. Material and Methods: Descriptive study including 755 Saudi volunteers living in Al- Qurrayat, Northern Saudi Arabia. Only for women agreeing to take part in the breast self-examination workshop had been blanketed and completed items of a scale assessing the knowledge level, attitudes regarding breast self-examination. Results: A total of 618/755 (81.9%) participant (622 females and 133 males), successfully completed the data. the majority of the participant about 34.7% were between 26-35 year. the level of knowledge in the participants about breast cancer perception according to their education is 16.6% of the respondents had no knowledge, about 5.7% of them complete the university. Also, 65.4% of the respondents had little and moderate knowledge and only about 17.4% had a good knowledge of breast cancer. In addition, 14.4% of female and 0.3 % of the male population had no knowledge about breast self-examination. Furthermore, 345 out of 755(45.7%) study population interested to get information about breast cancer were university educated. Conclusion: breast self-examination necessities to be taught to all women, irrespective of their education level