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

Background: Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm that originates in an abnormal pluripotent bone marrow stem cell and is constantly associated with BCR-ABL fusion gene. The present study was undertaken to obtain the clinical and hematological profile in adult CML patient. An attempt had been made to evaluate as well as compare the response of patients to the drugs - Hydroxyurea and Imatinib Mesylate. The earlier is an S phase acting agent and acts by inhibiting DNA synthesis while the latter is a potent and selective tyrosine kinase inhibitor. Methods: This was a prospective study done between January 2000 to march 2011 in department of pathology and medicine at Banaras Hindu University. A total 50 patients were studied. Exclusion criteria- pregnant ladies and children below 16 years were not included in the study. Patients on hydroxyurea were given 1000mg/day in chronic phases while those in accelerated phase and blast crisis received 30000 mg daily. The patients in imatinib mesylate group in chronic phase received single dose of 400-mg daily, while those in accelerated phase and blast crisis received 600 to 800 mg daily. Complete blood counts were monitored weekly for the first month, fortnightly thereafter till patient achieved hematological remission and then monthly. Interchange of patients among the groups was allowed. The diagnosis was based on general blood picture and bone marrow aspiration was ever needed. The standard criteria for the diagnoses of chronic phase, accelerated phase and blast crisis were used. Results: Chronic myeloid leukemia was commoner in males (male to female ratio was 1.4. Both the drugs were not age and gender sensitive. There was no significant difference in Imatinib and hydroxyurea group in mean post treatment TLC, mean post-treatment PLT, mean post-treatment HB, and mean post treatment spleen levels of patient according to the criteria of phases of disease though side effects were significantly lower with imatinib. Imatinib mesylate, a selective inhibitor of the protein tyrosine kinase has shown promising results in chronic myeloid leukaemia in all phases. Its efficacy, specificity and the safety profile makes it a better choice for the first line therapy in CML.

The study examined the relationship between Basic Accounting Education and the cost of governance in Nigeria. The population consisted of Federal civil servants and political office holders serving in the Akwa Ibom State. The simple random sampling technique was used in selecting 360 civil servants between salary grade level 10 and 15 from the Federal civil service to constitute the sample of the study. Two null hypotheses were formulated to direct the study. Data collection was carried out using a structured questionnaire tagged “Accounting Education and Cost of Governance Questionnaire” (AECGQ). The null hypotheses were tested at 0.05 alpha level using Pearson Product Moment Correlation Coefficient Analysis. The reliability coefficient stood at 0.78, justifying the use of the instrument. The two null hypotheses were rejected, indicating a significant relationship between Basic Accounting Education and the cost of governance in Nigeria. It was recommended, among other things, that every public servant and political office holder should be given Basic Accounting Education in order to master the rudiments of book-keeping and accounting records.

Diabetic foot infection is one of the most common complications of Diabetes and it is a major public health problem that leads to amputation if not treated. Moreover screening of the ulcers for microbial growth and antibiotic susceptibility will enable to initiate the appropriate antibiotic therapy. The present study was carried out to identify the profile bacterial pathogens from the diabetic foot ulcers and also to determine it’s antibiotic susceptibility pattern. Ninety four patients with diabetic foot ulcer attending Surgery outpatient department were included; demographic and clinical examinations was done by the surgeons and the ulcers were assessed as per the Wagner classification of ulcers. Wound swabs and pus were collected from the diabetic foot infections and were processed using standard Microbiological techniques. The results revealed Pseudomonas aeruginosa predominated followed by Klebsiella pneumoniae and Escherichia coli among negative groups whereas Staphylococcus aureus dominated [two strains were Methicillin Resistant Staphylococcus aureus (MRSA)], followed by Enterococcus spp and Streptococcus among Gram positive. The Gram positive bacteria showed resistance to cephalosporins, aminoglycosides and other first line drugs. ESBL production was observed maximum in Klebsiella spp followed by Proteus spp and Escherichia coli. Metallo β lactamases production for Pseudomonas spp was found to be positive among 12 isolates. Hence by performing culture and sensitivity of diabetic foot ulcers will enable the antibiotic sensitivity pattern which will be helpful in determining the drugs for the empirical treatment thereby preventing indiscriminate use of broad spectrum antibiotics.

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

The paper investigates the effect of female entrepreneurship on poverty in Cameroon. The two stage least squares estimation technique was used to estimate the parameters of both the female and poverty models for the period 1985 to 2016. Findings from data analysis revealed that female unemployment and domestic credit to private sector are key determinants to female entrepreneurship in Cameroon. Also female entrepreneurship was seen as a key factor in reducing poverty at a national level in Cameroon. From a policy perspective, an important conclusion is that for Cameroon to achieve the medium term objectives of poverty reduc tion as stated in the Poverty Reduction Strategy Paper (PRSP) and eventually to attain the long term vision of emergence by 2035, female entrepreneurship needs to be given more consideration in government’s economic policy.

Osteocalcin, the second most abundant protein in bone tissue is secreted by osteoblasts, was thought to participate in mineralization and calcium ion homeostasis. In addition to its use as biomarker in osteoporosis, recent studies have identified osteocalcin as an endocrine regulator of glucose metabolism, stimulating beta-cell insulin secretion and reducing peripheral insulin resistance. Insulin signalling in osteoblasts improves glucose handling directly by increasing secretion of active osteocalcin and indirectly by enhancing bone resorption which releases osteocalcin into the bloodstream. Thus in type 2 diabetes patient with insulin resistance serum osteocalcin level is decreased, which in turn affecting bone mineralisation. Aim: To look for an association of serum osteocalcin in type 2 diabetes mellitus. Materials and Method: The study population consisted of 46 type 2 diabetic patients as cases and 44 healthy subjects as contols. Fasting venous blood was collected from each subject and estimations of Serum Osteocalcin, Fasting Insulin, glycated haemoglobin, Serum ionized calcium ,Homeostatic model assessment (HOMA) is a calculated method used to quantify insulin resistance were done. Result: The serum osteocalcin was decreased in diabetic patients and was found to be statistically significant (P value 0.03). Serum osteocalcin negatively correlated with fasting blood sugar (r=-0.233), HbA1c (r=-0.160) and was statistically significant. Serum osteocalcin did not correlate with insulin resistance assessed by HOMA-IR, and fasting insulin. Conclusion: Serum osteocalcin was decreased in Type 2 Diabetic patients and negatively correlated with glycemic control. Thus a good glycemic control is essential part of bone health in diabetics individual.

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.

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

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.

This study aimed to find a lupus pattern of dyslipidemia in Systemic Lupus Erythematosus (SLE).Thirty SLE cases and thirty age matched controls are included in this study. Fasting venous blood was collected and base line investigations, lipid profile, apoB and apoA1 estimations were done. Statistical analysis was performed using SPSS package 19. The groups were compared using Student’s t test. Analysis of lipid profile across the cases and controls reveals that the mean triglycerides, the mean Low Density Lipoproteins and the mean Very Low Density Lipoproteins were higher among cases with statistical significance and the mean total cholesterol and the mean High Density Lipoproteins seen more in controls with statistically insignificant p value. Apo B values were high and low APOA1 values seen in SLE compared to controls. Higher Apo B/Apo A1 ratio in SLE cases. This ratio implies that the number of small dense LDL particles are the most atherogenic particles that are easily oxidize and promote inflammation and growth of plaques. This elevated lipid profile and apolipoprotein levels in SLE patients throws light on the fact that SLE patients are at increased risk for Coronary Artery Disease.

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.

A cancer diagnosis can have a huge impact on most patients, families, and caregivers. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing experience. Many things can cause these feelings. Changes in body image can affect self-esteem and confidence. Family and work roles may be altered. People might feel grief at these losses and changes. Physical symptoms such as pain, nausea, or extreme tiredness (fatigue) also seem more likely to cause emotional distress. People might also fear death, suffering, pain, or all the unknown things that lie ahead. Family often has these feelings, too. They may be afraid of losing their loved one. They may also feel angry because someone they love has cancer, frustrated that they “can’t do enough,” or stressed because they have to take on more at home. People with cancer, as well as their friends and family, can feel distress about these things at any time after a cancer diagnosis, even many years after the cancer is treated. As the cancer situation changes, they all must cope with new stressors as well as with the old, and their. Objectives: Assessment of depression, anxiety and distress in patients starting chemotherapy was done to study the level of later complications.

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.

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.