One of the most common chronic diseases in closely all states is Diabetes Mellitus. The world occurrence of diabetes amongst elderly (20-79) in 2010 was 6.4% distressing 285 million adult and all ages and probable to be increased to 7.7% distressing 439 million adult in 2030. In Pakistan Diabetes Mellitus (DM) the recent occurrence of type 2 diabetes mellitus is 11.77%. The prevalence is advanced between male than females, the occurrence of (DM) Diabetes Mellitus in urban areas are more common than rural areas. (DM) Diabetes Mellitus is a set of diseases categorized by great level of blood glucose causing from faults in insulin excretion, and its action or both. We compared the echogenicity of pancreas with the surrounding organ superior mesenteric artery (fat around (SMA). The size of the pancreas is slightly decreased as compare to the normal individuals. To determine the sonographic differentiation of pancreatic appearance between diabetic and non-diabetic individuals of age 45-55years. A cross sectional comparative study was conducted at Gilani ultrasound clinic Lahore. Total 150 individuals of both diabetic and non-diabetic were included in this study to compare the sonographic appearance of pancreas in diabetic and non-diabetic individuals. Peoples from the age group of 45-55 years are only included in this study. According to the result Fatty pancreas was seen on ultrasound hyperechoic and the normal pancreas was hypoechoic. The size of the pancreas is slightly decreased in diabetic patients as compare to non-diabetic individuals. Glucose level in diabetic patients was more than normal individuals. The mean age group was 49.9133. Out of 75 patients 43 patient pancreas were seen hyperechoic. The mean of pancreatic head was 22.22mm, pancreatic body was 21.11mm and pancreatic tail was 21.87mm. In our study female were more than male. Highly echogenic pancreas is associated with diabetes mellitus (DM).

CT scan is a revolutionized diagnostic imaging modality that allows threedimensional visualization of a region of the body in different planes. Besides its advantages, CT has disadvantages as well. The radiations used in CT scans are ionizing X-ray radiations which increase the risk of cancer progression. The rate of unnecessary CT scans has increased over the past few years which has resulted in increased exposure to the patient and increased healthcare cost as well. The aim of this study was to determine the actual rate of unnecessary CT scans in a tertiary care hospital of our country. The study was conducted on 385 patients in the Aziz Bhatti Shaheed Teaching Hospital, Gujrat in time duration of three months. It was an observational cross-sectional study. Scoring of the results was done by the co-supervisor having an experience of over 15 years. The scoring system was categorized from score 0 to score 2.Score 0 had no pathological finding, score 1 had suspicious finding and score 2 had confirmed pathological finding mentioned in the request form. A total of 385 patients were included in this research 162 females (42.1%) and 223 males(57.9%) with a mean age of 38.2±22.5-year (1-100 years).In this study 147 patients(38.2%) were categorized underscore 0 they were having no pathological finding and their results were normal,25 patients(6.5%) were categorized underscore 1 they had suspicious findings and were considered for follow up scan and the remaining 213(55.3%) patients were categorized underscore 2 they had confirmed pathology. Results concluded that the rate of unnecessary CT scans performed in this country is 38.2% which is considerably high. Unnecessary CT scans can lead to the risk of developing contrast-induced nephropathy (CIN) due to radiation exposure. The high cost of this test may cause a delay in the treatment of the patients.

The aim of the study was to of ventricular remodeling in patients with chronic heart failure (CHF) I-III functional class (FC). In patients with CHF left ventricular remodeling leads not only to re-structure of left ventricular (LV) which accompanied by dilatation and thinning of the cavity, reducing myocardial contractility, but also to changes of geometric shapes of left ventricular and to diastolic dysfunction of LV with domination of the disturbance of relaxation.

Hypertension is an important public health problem in both economically developed and developing nations. Worldwide, 7.6 million premature deaths were attributed to high blood pressure. Hypertension has been associated with increased risk of coronary artery disease and is an independent risk factor for cardiovascular and cerebrovascular diseases. The aim of this retrospective study about 312 cases was to determine differences in treatment and control rates of hypertension between male and female and to research the frequency of associated cardiovascular risk factors in the hypertensive population in Zaatari camp deployed in Jordan for Syrian refugees [9]. Our study confirmed the high prevalence of hypertension and associated cardiovascular risk factor. Although women are better treated, much remains to be done to reach BP goal for themselves and also for the rest of the patients.

Despite the availability of efficacious anti-obesity drugs (AOD), very few doctors are prescribing them to the patients. To assess the anti-obesity drug (AOD) prescription pattern in obese patients. Ninety four obese patients were studied at Department of Medicine and Department of Pharmacology, L N Medical College and research Center Bhopal, Madhya Pradesh from March 2017 to February 2018. Data analysis was done using SPSS ver 20 software. During this study 47% were prescribed metformin, 59% orlistat and 5% both drugs. Orlistat was largely prescribed independently [40 out of 50 prescriptions, 90%) and metforminon specialist recommendation (10 out of 40, 27%). Orlistat was largely prescribed in those over 16 years of age without physical comorbidities. Metformin was initiated for treatment of polycystic ovarian syndrome (70%), insulin resistance (25%) and impaired glucose-control (9%). Orlistat was the most common AOD prescribed in obese patients.

Recurrent pancreatitis is associated with minor duodenal papilla. Minor and major duodenal papillae are necessary for the endoscopist to perform the dilation, stenting, or papillotomy of the minor papilla. 50 formalin fixed cadavers (Male - 41; Female - 9) with age group ranged between 35 - 60 years from the departments of Anatomy, J.J.M Medical College, Davengere, Karnataka & Chennai Medical College, Trichy, Tamilnadu were utilized to study the position of minor duodenal papilla related to major duodenal papilla in pancreatico-duodenal specimens. The minor duodenal papilla was present in 46 (92%) out of 50 specimens whereas in 4 specimens (8%) the minor duodenal papilla was absent. The position of the minor duodenal papilla in relation to that of major duodenal papilla was recorded. In 37 specimens (80.43%) it was anterosuperior to the major papilla and in 9 specimens (19.56%) it was directly superior to the major papilla and opens at second part of duodenum. The distance between the minor and major papillae varied from 1.3 cm to 4.3 cm, the average being 2.35 cm was noted and recorded in the present study. Endoscopy assisted surgeries need anatomical knowledge in understanding the position of the minor duodenal papilla relation to the major duodenal papilla and its clinical importance.

Tea is common drinks in Saudi Arabia, as in the overall world for its desirable aroma, taste and putative positive physiological functions. According to recent estimates by FAO, approximately 5.35 million tons of tea were produced in the year 2013 with a total of 3.52 million ha land area under tea cultivation. Estimates show that approximately 70 % of the total world population consumes tea infusion (i.e., water extract of made tea). Contaminants may vary in the soil, air, or water in which the plants of tea are grown. There is an abundance of literature demonstrating the adverse health effects of various heavy metal and metalloid elements on the human organism. Our objective in this research is determination the trace metals which have directly effect on the human health and pollution of the environment. The samples were randomly collected from the markets and hyper markets in Eastern region, the collected samples of tea powder were stored at room temperature in dry containers for further process. The diluted digests analyzed by using Inductively Coupled Plasma (ICP-OES). The concentrations of anion groups in the selected samples were high and might affect the health of the consumers of the tea as the result showed; SO4 was ranged between 16 to 35 mg/L, NO3 was ranged between 0.1 to 5.8 mg/L, NO2 was ranged between 0 to 0.012 mg/L, PO4 was ranged between 0.29 to 1.28 mg/L and NH3 was ranged between 0.36 to 0.49 mg/L. The concentrations of nontoxic heavy metals in tea samples also were high e.g., Ca concentration (mg/kg) the maximum concentration was 173.31 and minimum concentration was 48.55, Fe concentration (mg/kg) the maximum concentration was 49.861 in some of the samples. K concentration (mg/kg) the maximum concentration was 158.96 to 101.69, Mg concentration (mg/kg) the maximum concentration was 150.24 and minimum concentration was 24.913. About toxic heavy metals in tea samples such as Al concentration (mg/kg) the maximum concentration was 47.276 and minimum concentration was 18.925, Cd concentration (gm/kg) the maximum concentration was 0.0339 and minimum concentration was 0, Cr concentration (mg/kg) the maximum concentration was 1.9132 and minimum concentration was 0, Pb concentration (mg/kg) the maximum concentration was 72.317 and minimum concentration was 0.1185.

Chalk board talk lecture is the oldest and most commonly used teaching method. After introduction of digitalized teaching in medical colleges Power point presentation Lecture method is commonly used. To evaluate the feedback from first MBBS students regarding opinion and preferences of chalk board and PPT lecture delivery aids. A cross sectional questionnaire based study was conducted in medical college in Telangana State .150 first MBBS students participated in this study. Students were divided into 2 groups .In one group Lecture was delivered by using chalk board, for second group same topic was delivered using PPT presentation, two such lecture were delivered. Multiple choice questions paper was used for assessing the knowledge gained on next day. A questionnaire containing 10 questions was used to study students opinion for blackboard and power point teaching method. The differences in marks obtained in the 2 groups were analysed by independant student t test. Students who attended the lecture using chalk board obtained higher score in MCQ test as compared to those who attended the same lecture using PPT. The chalk board teaching method was preferred by 65% of the students. The blackboard teaching remains the best preferred teaching method, which can be supplemented by PPT presentation for better understanding.

Poor response of fungal nail infection to topical treatment with antimycosis is probably related to poor drug permeation into the infected nail. Niosomes are the nano carriers which play an increasingly important role in drug delivery as they can reduce toxicity and modify pharmacokinetics and bio availability. Oxiconazole nitrate is a potent antifungal drug used in the treatment of fungal infections. The aim was to develop Oxiconazole nitrate Noisome using thin film hydration method and optimized for molar quantities of span 60 and cholesterol to impart desirable characteristics. And the formulation was evaluated for entrapment efficiency and invitro drug release. The entrapment efficiency was found in the range of 76.05-94.64%and invitro drug release in the range of 49.03-67.26%. Oxiconazole Nitrate Noisome formulated with span 60 and cholesterol in the ratio of 1.5:0.2 were found to be promising and were incoparated into 1% carbapol gel. The formulated gel was evaluated for various physicochemical parameters and antifungal activity. The invitro drug release study was carried out using phosphate buffer saline pH 7.4 and was found to be 67.95% in 6 hours. Gel formulation containing Noisome loaded with oxiconazole showed prolonged action than the non niosomal form and it can be developed successfully to improve antifungal activity.

The healthcare service area while providing services, curative, primitive or preventive inevitably create waste which itself may be harmful to health. It carries a higher latent for infection and injury than any other type of waste. Inadequate and inappropriate knowledge of handling of healthcare waste may have serious health penalties and a significant impact on the environment (Suwarna Madhukumar April 2012)... Insufficient and inappropriate knowledge of waste and handling of waste may have serious health complications. To determine awareness of infectious waste management among staff nurses and describes their level of knowledge, attitude and practice towards infectious waste management. A cross-sectional analytical study design was used to observe the knowledge, attitude and practice of staff nurses. A cross-sectional is that study that collects information from a population at specific time of period (Lisa B 2014). Data was collected from 50 nursing staff through convenient sampling techniques. Those who meet the inclusion criteria will be included in the study and those who don't meet the criteria were not being the part of the study. Data was analyzed through SPSS version 16. Results suggests that there was unsatisfactory knowledge among nursing staff of mayo hospital Lahore.50% of the study participants had knowledge about infectious waste management , other 50% had poor knowledge regarding waste management techniques and procedures. Red container is used for cytotoxic items. Out of 50, only twenty six (52%) study subjects answered full destruction of all cytotoxic substances require incineration at high temp up to 1200 degree centigrade.30%subjects did not comment. Participants had poor practice related to sharp items wasted only 19% participants knows yellow puncture proof container is used for sharp items. Forty two (84%) Nurses were aware about containers should be filled three quarters full and then disposed. Only 8%nurses knows Hepatitis B is greatest risk from infectious hazard.54%nurses assume that Hepatitis C is greatest risk. The attitude of the study subjects toward awareness of waste management, separation of infectious and noninfectious waste, proper disposal and implementation of rules was positive. According to my results nursing staff had poor knowledge so that their practice was also poor and unsatisfactory .they all need regular training and monitoring.

The study undertaken the assessment of awareness and specific knowledge, perceived susceptibility, perceived seriousness of breast cancer and perceived benefits of screening for early detection and treatment of women in a differ community. The study also measured screening behavior among the participants. Therefore, the aim of this study was to assess and compare the knowledge and perception of Saudi Arabia and Sudanese people towards breast cancer prevention and early detection. In this comparative, cross sectional study, data about breast cancer were obtained from 1000 participants: 500 Saudi volunteers living in the city of Hail, Saudi Arabia and 500 Sudanese volunteers living in Khartoum city. The level of individual's knowledge about breast cancer was assessed, the majority of the study subjects were found with moderate knowledge followed by good, Excellent, poor and no knowledge representing 432(43.3%), 332(33.3%), 116(11.6%), 107(10.7%) and 10(1%), respectively. For Saudi, most of them were found with moderate knowledge followed by excellent, good, none and poor knowledge constituting 66(27.2%), 112(46.2%), 32(13.2%), 29(11.9%) and 3(1.2%), respectively. For Sudanese, most of them were found with moderate knowledge followed by Excellent, good, none and poor knowledge constituting 266(35.2%), 320(42.3%), 84(11.1%), 78(10.3%) and 7(0.9%), respectively. The overall knowledge of the studied population about breast cancer prevention and early detection was relatively low. More community based health education efforts are needed to reduce the burden of breast cancer in both nations.

Garment factories in India is the second largest sector for employment, approximately 60% of the population employed in the garment industry are women. Menstrual cycle is a physiological phenomenon during reproductive life of women. Its phases are influenced by alteration in the concentration of hormones such as estrogen and progesterone. Fluctuating levels of sex steroids across normal menstrual cycle affect sensory- motor association of an individual. So this study was done to assess the muscle performance capability in terms of hand grip strength (strength of upper limb muscles) as Maximum Voluntary Contraction (MVC) and time for fatigue at 30% of MVC during Menstrual, Proliferative and Secretory Phase of menstrual cycle among 54 garment workers. Maximum voluntary contraction was higher during secretory phase than proliferative and menstrual phase. And time to fatigue at 30% MVC was also found to be higher during secretory and proliferative phase compared to menstrual phase. Overall muscle performance capability was found to be better during secretory phase of menstrual cycle, may be due to increased blood flow to the muscle and glycogen storage under the influence of estrogen and progesterone. Estimation of female sex hormones during different phases and its correlation to muscle performance may reveal more facts.

The tibia is the strong weight bearing bone of the leg. It has usually a single nutrient foramen. Of late, tibia is gaining importance in determining the stature, sex and race of individuals and in the identification of missing persons. The dry bone specimens were obtained from the department of anatomy of our institution. A total of seven morphometric parameters were obtained for the study. The number of nutrient foramen present and their location were recorded. The cross sectional index, cnemicus index, length-thickness index, and the proximal - distal surface index were arrived from the data obtained. A single nutrient foramen was observed in the study; located in the upper one third of tibia in its posterior surface. The results are presented as descriptive statistics (mean ± SD); and standard errors of estimate (SEE) for right and left tibia and total tibia. The mean differences obtained are not statistically significant. The confidence interval of SD or SEM is less than 1. The two – tailed P value equals less than 1and is not statistically significant. Tibia has a single nutrient foramen in the upper one third of tibia in its posterior surface. The morphometric parameters obtained and the indices derived differed widely among the different studies. The differences may be due delicate variations in the measurements. There is a need for defining the parameters by further studies for the better utilization of morphometry of tibia.

This research aimed to investigate students’ Physics achievement through implementing STAD (Student Teams Achievement Division) derived from cooperative learning with animation as media. The population of the research was grade XII students of senior high school MAS TPI Rambung Sialang, North Sumatera Indonesia, then two classes were chosen as sample of the research in which there were 30 students for each of class. To meet the objectives of the research, quantitative research method with experimental research design was conducted, then, the instrument of the research was comprehensive multiple choice with 20 questions formulated. Through Lilefors test with L0< L = 0.1384 < 0.1610, it showed that all the data were distributed normally, then, all the data were distributed homogenously as well with Fobserved<Ftable(1.191< 1,858). Morever, based on data analysis it was found that the average score of experimental class I taught by implementing STAD (Student Teams Achievement Division) with animation as media was higher with ̅ = 14.9 than experimental class II taught by conventional model with ̅ = 12.5. Furthermore ttest was used to analyzed the data found with tobserved> ttable (2.654>1.671) that showed that there was a significant effect on students’ Physics achievement taught by implementing STAD (Student Teams Achievement Division) with animation. Based on data analysis, it could be inferred that students defintely enjoy studying in group discussion that was organized by the teacher in which the members of group consisted of student with different intelligence level so that there would be an interaction among students accross capabilities level. The students with higher intelligence were expected to assist the students with lower intelligence, then students with higher intelligence that were recognized as an expert representative from each group would have a great an opportunity to share the discussion result with other groups. Besides, the use of animation as media brought up functionally and lively understandable objects, concepts, and formulas. Hence, all the abstract concepts seemed to be effortlessly more concrete for the students

Automated counts are being widely accepted in diagnostic field due to various advantages. Despite the sophistication of present day instruments there is still need to depend on manual techniques for primary calibration especially in case of platelet count. Automated analyzer had pitfalls due to mimickers of platelet like particles which validated the manual count in peripheral smear regarding platelet count by leishman’s stain. A cross sectional study was conducted in a tertiary care hospital for 3 months. It includes 1200 venous samples with EDTA as the anticoagulant in vacutainers. Among the routine 100 to 120 samples/day, with platelets < 1,00,000 lakhs /cumm of 500 samples were subjected for study. Samples were processed by Symex 5000 autoanalyzer and compared with manual platelet count by leishman’s stain. About 500 samples with platelets < 100,000 lakh/cu.mm were taken for study. In 384/500(76.8 %)haematology analyzed correlated with peripheral smear review. About 116(23%) were not correlating with peripheral smear findings because it revealed RBC’s and large platelets in peripheral smear. Our study concludes there was significant correlation between automated and manual counts. But this was not applicable for very high or low platelet counts.As platelet count estimation is very important element of the diagnostic and treatment disorder.Peripheral smear examination along with automated analyzer valid in case of high or low value platelet counts.