Gall Bladder Carcinoma (GBC) is the most aggressive and most common malignancy of the biliary tract in the world. GBC is common in India and shows rising trend with 10 times more incidence in northern and north eastern region than Southern region. As most of the patients are diagnosed in the advanced stage of cancer, prognosis is dismally poor and early diagnosis is essential. We aim to study the importance of Ultrasound (US) guided Fine Needle Aspiration Cytology (FNAC) in the early detection and diagnosis of gall bladder malignancy in the suspicious cases of gall bladder lesions. A prospective cytomorphologic analysis of total 580 cases of suspected gall bladder lesions was conducted in the Department of Pathology, SMS Medical College, Jaipur, Rajasthan over a period of 2 years. US guided FNAC of the suspicious lesion was done and diagnosis was made on the basis of their cytomorphological features. The mean age of presentation was 54 years with male: female ratio of 1:2. The most common site for GBC was found to be Fossa (97.4%). According to nature of the smears, 73% were malignant, 18% unsatisfactory, 7% benign and 2% were suspicious. On cytomorphological diagnosis, Adenocarcinoma was found to be the most common of all malignant neoplasm (42%), followed by cholangiocarcinoma (9%), MEN (8%), metastatic (05%), adenosquamous (3%) and squamous cell carcinoma (1.5%). We concluded that US guided FNA is safe, quick and reliable procedure for an early diagnosis and pre therapeutic workup for gall bladder lesions.

Objective: To determine students perspectives about effectiveness of teaching learning strategies used by nurse educators. Study Design: A cross- sectional study. Place and Duration: Isra College of Nursing Islamabad from June 2017 to September 2018. Methodology: A Structured questionnaire, including demographic information and questions regarding use of teaching learning strategies, was used. To assess the students perspectives about the effectiveness of these strategies five-point likert scale was used which include from marking point 1 for not effective to 5 for very effective. Data was analyzed using SPSS version 22. Results: Mean age and standard deviation of the participants was 28.5 ± 4.7 years respectively. In total, 36 students participated out of which 11 (30.5%) were male, whereas 25 (69.5%) were female. The most effective teaching learning strategy student perceived was case scenario and 77.8% found it very effective followed by group teaching which was found very effective by 47.2% of students, However the least effective strategy was cooperative teaching because only 11% of the students established it as effective. Conclusion: This study concluded that student perceived case based teaching as most effective teaching learning strategy than other educational methods, however students also forechoose the use of multiple teaching learning strategies for overall group learning

The year 2009 witnessed emergence of novel H1N1 subtype of influenza A virus. This novel strain rapidly spread across the world and caused pandemic. In 2010, WHO declared pandemic to have crossed its peak and also warned that it will continue as seasonal influenza outbreaks in winter seasons. Several aspects of the epidemiology of influenza A H1N1/2009 strain have not been accurately determined. We sought to study whether the age & gender affects susceptibility to influenza. During the study period of one month, patients categorised as category C under national influenza guidelines and admitted to isolation ward were screened for influenza. Real-time reverse transcriptase PCR (rRT-PCR) was used for detection of influenza viral RNA. For PCR setup, WHO & CDC guidelines were followed. The result given was either Influenza A/H1N1/2009pdm strain positive or negative. Out of 75 samples received in the laboratory, 32 samples were positive (positivity rate of 42.66%). Positivity rate for females (46.51%) was higher than males (37.50%). Positivity rate was maximum in 70-79 years age group (100%) followed by 30-39 years age group (46.15%) and 20-29 years age group (44.44%). None of the patient was positive in 10-19 years age group (Positivity rate of 0%). The influenza (H1N1/2009) virus is still active several years after the 2009 pandemic in the various parts of the world. The incidence of H1N1 influenza is higher in old individuals. This emphasizes importance of vaccination especially in high risk group before the start of the flu season.

Objective: The point of this examination was to assess the criticalness of the fetal kidney length (FKL) for the estimation of gestational age. Method: A cross sectional study was carried out on 399 pregnant women with singleton pregnancies having no complications at Baloch Hospital Lalian. Pregnant women with single fetuses underwent standard ultrasound fetal biometry. The fetal kidney length measurements were performed from 20th weeks to 38th weeks of gestation. These measurements were used to date the pregnencies. Results: A positive linear relationship was found between gestational age (measured by femur length) and length of left kidney. G.A in weeks (measured by femur length) = 25.430+1.912 (Left Kidney in cm) with R2=0.939 and p value=0.000<0.05. Another statistically significant positive linear relationship was found between gestational age (measured by femur length) and length of right kidney.G.A in weeks (measured by femur length) =13.496+5.727(Right Kidney in cm) with R2=0.939 and p value=0.000<0.05. Conclusion: FKL is easy to identify and measure. It is most accurate single parameter for estimating GA than other biometric indices especially in cases when the other parameters like BPD, FL, AC and HC are not reliable for assessing GA in the 2nd and 3rd trimester of pregnancy

Background: Dengue fever (DF) and dengue hemorrhagic fever (DHF) are important arthropod borne viral diseases. Dengue is emerging as major public health concern in India and spreading with increased morbidity. Objective: This study was carried out to determine the seroprevalence of Dengue infection among patients attending in Gandhinagar civil hospital attached with medical college during the period of January 2018 to December 2018. Methods: A total of 2545 blood samples received in the department of microbiology, were tested for the confirmation of suspected cases of dengue. Dengue NS1 antigen and Dengue IgM antibody ELISA tests was performed for the confirmation of dengue cases. We estimated the incidence by applying age, sex and season adjusted dengue positivity. Results: Out of 2545 samples tested, 639were positive for dengue infection, among the positive cases 503 were NS1 antigen ELISA positive and136 were IgM ELISA positive. Higher incidence in male patients was noted. Number of positive cases was increased in rainy season. Conclusion: Virus activity is high during monsoon and post monsoon period which coincides with increased vector breeding. This study thus emphasizes the need for continuous sero epidemiological surveillance for the timely formulation and implementation of effective dengue control programme.

Depression is largely experienced in our societies. It is costly and highly prevalent medical condition having a lifetime prevalence of around 16% in US adults. Around 13.5 million adults got major depressive disorder in the last year and 34 million will get it at some point. Women experience it more likely about 1.5 to 3 times greater than men. Anyone can experience it at any age but most people experiences first episode in their early thirties. This review represents different factors that are associated with depression

Background & Objective: Hepatitis B and Hepatitis C are significant problems in the management of haemodialysis patients. We aimed to investigate the incidence and prevalence of HBV and HCV infection in the hemodialysis patients as well as risk factors for infection. Methodology: All adult patients receiving maintenance hemodialysis (n=217) in General hospital, gandhinagar were studied between September to December 2018. Testing for Hepatitis B surface antigen (HBsAg) and anti-HCV antibodies was performed at Department of Microbiology, GMERS medical college, Gandhinagar. Results: The prevalence and incidence rates were 2.30% in HBV patients and 5.06 in HCV patients respectively. There was a significant correlation of the prevalence and seroconversion of HCV and HBV with number of blood transfusion and duration of heamodialysis. Conclusion: Patients on maintenance hemodialysis have lower incidence and prevalence of HCV infection and lower rates of HBV infection in this study.

Chronic renal failure is one of the slowest progressive and irreversible diseases of kidney function which is characterized by low glomerular filtration (GRF). Chronic kidney diseases (CKD) is the 17thcause of disability and 12th major cause of death. Dialysis is the artificial way of carrying out removal of toxic metabolic products from blood, when the kidneys are not functioning. Even though there is a dramatic improvement of dialysis technology and pharmacological treatment, mortality rates for dialysis patients are still high. In India within a year approximately 9-13% hemodialysiate patients die. Highest cause of mortality among CKD is sudden cardiac death (SCD), in which death occurs from sudden unexpected cessation of cardiac activity with hemodynamic collapse. Serum creatinine and urea are considered as the most sensitive markers for the detection of the renal failure. In CKD patients one finds both hyperkalemia and hypokalemia which can be due to a decreased kidney function or due to diuretic administration eventhough their impact on mortality and end-stage renal disease (ESRD) is not very well understood. The present study was undertaken to evaluate the pre and post dialysis samples for values of renal biochemical markers like serum urea, creatinine and electrolytes. Total 68 CKD patients were observed. Statistically significant difference was observed between pre and post dialysis blood urea, serum creatinine, sodium and potassium levels. Hemodialysis is an effective and efficient process in removing these undesirable metabolites, helps increase life expectancy.

The aim of our study is to assess the frequency of urinary tract infections in clean catch midstream urine, to isolate the urinary tract infection causing organism and their anti microbial sensitivity to various antibiotics in chronic renal failure patients undergoing hemodialysis. Our study was carried out in the time span of 12 months from January 2018 to December 2018 at GMERS Medical College Gandhinagar, Gujarat. The study included 1225 patients of all age group who had clinically evident chronic renal failure and taking hemodialysis. Out of 1225 patients presented clinically as chronic renal failure and taking hemodialysis, 365(29.80%) patients were culture positive and 860(70.20%) patients were culture negative. Out of 1225 patients of CRF taking hemodialysis 891(72.73%) were male and 334(27.27%) were female. In the present study maximum number of patients 97 were from age group 61-70 years followed by 57 patients from 21-30 years age group. Out of 365 cultures positive isolates 301(82.47%) were gram negative isolates and 64(17.53%) were gram positive isolates. Both gram negative and gram positive isolates are 100% sensitive to imipenam and least sensitive to amoxicillin 15.28% and 10.94% respectively. MDR in gram negative isolates were 19.27% and in gram positive isolates were 12.69%. our study is helpful in need for continous evaluation of local antibiotics sensitivity patterns for the formulation of rational antibiotic policy which will reduces further spread of antimicrobial resistance.

Generally speaking, listening, speaking, reading and writing are four basic skills for English learners. Reading as a mean to learn English is indispensable in the process of English learning. Thus, English reading comprehension is especially important for English learners. However, grammatical metaphor in reading materials is always one of the reasons that cause troubles for English learners. Because of grammatical metaphors students may miss or misunderstand some important information in English reading materials. Thus, it is essential to conduct a deep research on grammatical metaphors. And this article will explore how interpersonal metaphors influence students’ English reading comprehension. This article will explore this kind of influence from two aspects: one is the Mood metaphors; the other is the Modality metaphors. In addition, some cases will be listed to support the ideas. Meanwhile, some feasible suggestions on English reading comprehension will be put forward

Blood transfusion is most important part of medical treatment and is also associated with risk of transfusion transmitted infections (TTIs). Hence screening of blood bags is important to ensure safe blood transfusion. The present study was done to evaluate the ability of nucleic acid testing (NAT) and to compare it with ELISA assay to detect Window period for HBV, HCV, and HIV in the donor population of the blood bank of Karwar institute of Medical sciences, Karwar, Karnataka. A total of 3183 donors were screened over 4 ½ years to assess the seroprevalence of infectious disease markers. Blood units were screened for the five commonest TTIs namely HIV I & II, HBsAg, HCV syphilis and malaria using screening test like ELISA and Rapid Kit, peripheral smear and VDRL tests. All reactive sample were retested. Seropositive blood bags were discarded. All non-reactive samples were sent for confirmation testing by NAT technique for HIV I & II, HBsAg, HCV to reduce the risk of TTIs in the recipients, thus providing an additional layer of blood safety. Out of 3183 blood donors, 17 were seropositive for the TTIs. Totally 14 units were positive for HBV infection, out of those 13 were detected HbsAg positive by ELISA and 1 seropositive donor which was not detected by the serological test was detected by the NAT. NAT implementation is likely to reduce the TTIs and its implementation will be a valuable addition to the existing safety efforts.

Infertility affects about 10-15% of reproductive age couples globally. WHO estimates 60-80 million couples worldwide. WHO estimates the overall prevalence of infertility to be between 3.9 to 16.8% (WHO estimate 2004) [2]. Diagnostic hysterolaparoscopy is an effective modality for evaluation of tubal and peritoneal pathologies, endometriois, pelvic adhesions and intra uterine pathologies, which are not identified with other imaging modalities and routine pelvic examinations. Tubal patency is evaluated simultaneously by direct visualization of spillage of dye through the tubes. This retrospective study is undertaken to evaluate the effectiveness of diagnostic hysterolaparoscopy in infertility workup. Results were analyzed and the abnormal pathologies were categorized. Safety and advantages of Diagnostic hysterolaparoscopy procedure was observed

This study aims to look at the rate of primary productivity utilization in Jakarta waters by fisheries activities which are divided into two main zones using the Human appropriation of net primary production approach and the primary production recquirement. The fishery zone is divided based on the type of vessel weight size, namely zone I for ships with sizes <5GT and zone II for 5-10GT vessel sizes. The method used in calculating PRRi is to use the approach of Pauly and Chirstensen (1995) while for HANPP we transform the approach of Erb et al. 2009 to the Djau 2013 approach to see the value of HANPP fisheries. From the analysis, it can be seen that the PPR value for zone I is equal to 1,63 x 108 kgC.y-1 while for zone II amounting to 1,44 x 108 kgC.y-1. For HANPP value for zona II is equal 5,12 x 1010 kj and zone I 4,04 x 1010 kj. Total value (zona I dan II) PPRo = 9,88 x1010 , PPRh = 7 x 109 kj, and HANPP total = 9,17 x 1010 kj. The conclusion from this analysis is shown that harvesting rate of primary productivity by fisheries in Jakarta waters reaches more than 95% of total energy availability it means that the fisheries activities has given considerable pressure to the waters.

Organophosphorus compounds are organic compounds containing phosphorus. They are used primarily in pest control as an alternative to chlorinated hydrocarbons that persist in the environment. Some organophosphorus compounds are highly effective insecticides, although some are extremely toxic to man, including sarin and VX nerve agents. To study the myocardial involvement in organophosphorus compound poisoning. Patients got admitted to the department of medicine, Adichunchanagiri institute of medical sciences, with history of organophosphorus compound poisoning during the period of January 2016 to December 2016. In the preset study, the incidence of OP compound poisoning common in males compared to females. Majority of patients were in the age group 31-49 years. The most common clinical finding in patients was tachycardia (36%) followed by bradycardia (32%). Hypertension was seen in 5 (20%) patients and 4 (16%) showed hypotension. Most common ECG finding was ST elevation (48%), Sinus tachycardia (24%) and QT prolongation (16%) and sinus bradycardia (12%). 15 (60%) of the patient had a significant levels of serum Acetylcholinesterase level >2500 IU/L. Cardiovascular effects are quite common following acute OP poisoning. These effects pertain to different muscarinic and nicotinic effects on the heart, electrolyte disturbances, ABG disorders, respiratory failure and over-atropinization.

Jute seed production season, methods and related practices for yield and their economics were selected for its being large concentration point in relation to production methods, yield and cost in Bangladesh. The technical review paper provides crucial insights regarding the past, present status and future prospects of jute seed scenarios of the country. The whole contents of the article covering all aspects of jute seed including strategies in overcoming the acute jute seed shortage of the country. Data were collected from different print media like different annual reports and journals during the year 2018 at Agronomy Division, Bangladesh Jute Research Institute (BJRI), Dhaka. Jute is grown in about 0.8 million hectares of land by about 3.5-4.0 million farmers. To cultivate that amount of land, the it require about 5000 to 5500 tons of seed. One of the most important problems for jute production in Bangladesh is the non-availability of quality seed at proper time of sowing. Only about 15%-20% quality jute seeds are supplied by institutional sources however the rest amount of quality seeds yet to be managed to supply. Bangladesh Jute Research Institute (BJRI) produces nucleus seed to produce “Breeder seed” duly certified by Seed Certification Agency (SCA). Bangladesh Agricultural Development Corporation (BADC) collects Breeder seeds from BJRI for producing Foundation seeds at its own multiplication farms. BADC produces certified seeds through its contract growers. Besides, BJRI also produces 8-10 tons of Truthfully Leveled Seed (TLS) and distributed to the farmers. Since its inception BJRI has developed 42 varieties of jute fibre crops. Jute seed could be produced by direct seeding, plant top/stem cutting and seedling transplanting methods, called improved methods. In traditional method it took 240 to 270 days of field duration for seed production. In contrast 120 to 160 days of field duration required for any improved method. Seed sowing generally done during March-April for jute fibre, a part of matured plant’s of the same land kept for seed production in traditional system. However, in off-season, June-July was proved appropriate sowing time for Corchorus capsularis L.