Introduction: Sjögren's Syndrome is a complex and chronic autoimmune disease that affects the salivary and lacrimal glands, however the immunoregulatory and immunosuppressive effect of vitamins has been related to the disease. The objective was to know the vitamins related to the Sjögrens Primary Syndrome compared with a control group. Materials and Methods: A review was made in the PubMed database with the key words (Vitamin and Primary Sjogrens Syndrome and Primary Sjögrens Syndrome) without restriction of date until November 2, 2018, only studies conducted in humans and published in English were selected. Results: We identified 50 studies with the search criteria, 5 studies were conducted on animals and were excluded, 7 studies were written in a language other than English and were excluded, only 38 studies were eligible and 7 of them were included. The vitamins A, D, E, and 25 hydroxyvitamin D3 were analyzed in the pSS compared to a control group. Conclusion: The vitamins D are important to balance calcium, phosphorus for the development of bone tissue and in patients with pSS the musculoskeletal system may be affected.

The purpose of this research was to identify the internal and external factors to formulate strategy and to prioritize alternative strategies for increased local tax revenue BPHTB. The research are using Internal Factor Evaluation and External Factor Evaluation, SWOT analysis and Analytical Hierarchy Process (AHP). The results indicated that the emergence of factors that affect the goals are (1) facilities and infrastructure (2) BPHTB regulation (3) updated NJOP (4) the growth of the industrial property (5) the integrity and capacity of human resources (6) awareness and knowledge of the taxpayer. Actors who influenced in this study is the tax payers, tax officers, internal Auditors and Notary Public/PPAT. The increase of capacity and integrity was selected as the priority strategy based on AHP research. Managerial implications of the human resources improvement program is oriented on increased local tax revenue BPHTB based on the principle of good governance. This research was the top recommendation of the deregulated of regulation BPHTB to anticipating the loss of potential revenue BPHTB and for the Central Government BPHTB along with the House of Representatives (DPR) for the amendment UU Nomor 28 Tahun 2009

The aim of this study is to find out the relationship between corporate governance (measured by: institutional ownership; board of commissioner; and independent commissioner), tax avoidance, leverage and company size to earnings management. Based on previous research, we identify some factors can make the company doing earnings management such as corporate governance, tax avoidance, leverage, company size. This research took population and sample from banking companies that listed in IDX 2015-2017. The results show that institutional ownership has significant effect to avoid earnings management. These results also showed that tax avoidance, leverage, Size Company has no significant effect to avoid earnings management.

Nasal obstruction (NO) is defined as a single or bilateral nasal breathing disorder, recent or old, permanent or intermittent. It is a frequent problem in pediatrics and underestimated because of the absence of complaint in young children or unknown when the complaint is unilateral [1]. Although the majority of causes of ON belong to the infectious pathology, one must know to think of a syndrome malformative or tumoral [2]. The ON can cause significant troubles both locally and generally [1]. It is necessary to objectify the cause quickly especially in the newborn because of the vital consequences that this obstruction can cause [1].

Dermatoglyphic analysis is one of the most authentic biometric technologies that provides authorized certification of identification. The present prospective study involves 114 female nursing students on an attempt to find out a correlation between the fingerprint pattern and ABO blood group system. It is a double-blind study wherein attentive supervision were done while examining the blood groups and collecting the fingerprints. The results unveil the fact that all the patterns are distinctive. The count of samples is far more in blood group „A‟, „B‟ and „O‟ as and when compared to that of „AB‟. Based on the prevalence of palmar sequences, loops are found to be the most common pattern, followed by whorls and arches. A further in-depth study suggests that the incidence of loops was more in the thumb, middle and little finger whereas whorls are prevalent in the index finger of A, B, and O blood group of both the hands. Definitely, a close association is found between the palmar patterns and individual digits of the left and right hand with the blood groups.

The malignant hyperthermia is a rare autosomal dominant disease of the skeletal muscles. Triggered by volatile anesthetics and succinylcholine which leads to excess release of calcium from sarcoplasmic reticulum that leads to hypermetabolic status of the body and it could be fatal. The incidence between 1:10000 and 1:250000 anesthetics. It is more common in males than females, and the young more than old people. MH cause by mutation in RYR1, CACHA1S or STAC3 genes. Symptoms of MH are muscle rigidity, tachycardia, hypercapnia, hypoxemia and hyperthermia. The symptoms of MH could be mistaken by other conditions and therefore delay the treatment. Treatment is by stopping the triggering agent, symptomatic treatment to prevent complications and the only pharmacological agent that reverses the MH is Dantrolen. IVCT is the gold standard to diagnose MH but it is invasive. Genetic testing is less invasive and also help in diagnosis of MH and identification of the affected gene, but it does not replace IVCT.

The purpose of this study was to find out the effect of trust, security, quality of service and perceived risks on online purchasing decisions. To investigate thehypotheses of the research, data were collected through distributing questionarre with a samplesize of 385 samples.The questionnaire consisted of a list of statements submitted to respondents to obtain data relating to research. The methodology was conducted usingStructural Equation Modeling (SEM) program, and LISRELsoftware to perform factor analysis. The study revealed that trust variable on online Purchasing Decisions (PD) had positive and not significant effect with t-value of 1.38 and the estimated value of 0,19. The effect of Security Variable on Purchasing Decisions (PD) had a positive and not significant effect with t-value of 0.87 and estimated value of 0.12. The effect of Quality of Serivice (QS) on Purchase Decisions (PD) had a positive and significant effect with t-value of 6.03 and estimated value of 0.37. The effect of the Perceived Risk Variable on Purchasing Decisions (PD) had a positive and significant effect with t-value of 5.82 and estimated value of 0.44. The Quality of Serivice (QS) variable had a dominant effect on online purchasing decisions through Social Networking Websites compared to the Perceived Risk variables, Trust Variables and Security Variables

Fatigue is often cited as a contributing factor in air incidents and accidents. Usually, the words "fatigue" and "sleepiness" are used by aircrew to describe the same feelings, a questionnaire has been developed for subjective level assessment of fatigue and sleepiness among Moroccan aircrew. A 4-month prospective study including all aircrew (civilian, military) and air traffic controllers was conducted at the Aero-medical center of Rabat during their review visit. The questionnaire included the Pichot scale for fatigue and Epworth scale for sleepiness. It was filled anonymously. Out of more than 400 cards distributed, only 200 were exploitable. 23% of the subjects in the study had moderate fatigue. 6.5% of the sample presented moderate sleepiness and 4.5% had excessive daytime sleepiness. These two states seem to be preponderant in young aircrew population especially cabin crews. The occurrence of fatigue and daytime sleepiness in aircrew especially at the beginning of their career can be explained by the difficulty of adapting to aeronautical constraints. It is important to remember the countermeasures of fatigue to preserve aviation safety

The study was conducted in five major Binasoybean-2 growing areas of Bangladesh, namely Noakhali, Laxmipur, Chandpur, Barisal, Comilla. The major shares of total cost were human labour, power tiller, fertilizer and irrigation. The average total cost of production in field level of Binasoybean-2 is Tk. 31382.71. The net returns were Tk. 39738.40, Tk. 32353.80, Tk. 31467.89, Tk. 30499.63 and Tk. 20688.88 ha-1 followed by Chandpur, Laxmipur, Noakhali, Barishal, Comilla, respectively. The highest net return (Tk. 39738.40 ha-1) was found at Chandpur district and the lowest net return (Tk. 20688.88 ha-1) comes from Comilla district for Binasoybean-2. The undiscounted benefit cost ratio over full cost basis were 2.29, 2.02, 2.01, 1.98 and 1.65 for Binasoybean-2 in field level for Chandpur, Noakhali, Laxmipur, Barishal and Comilla, respectively. The highest Benefit Cost Ratio (BCR) is 2.29 in Chandpur district and the lowest BCR is 1.65 in Comilla district. The highest yield gap between research station and field level was in Comilla (397.50 kg ha-1) and lowest in Chandpur (83.50 kg ha-1). The yield gap between research station and farm level in percentage were 18.30, 8.49, 11.48, 40.43 and 21.30 for Binasoybean-2 in Noakhali, Chandpur, Laxmipur, Comilla and Barishal, respectively. Binasoybean-2 growers faced various constraints to Binasoybean-2 cultivation like, disease and pest infestation, non-availability of quality seed and fertilizer at proper time, lack of soil moisture during sowing time, lack of credit facilities etc. Binasoybean-2 production in the study areas is profitable. Binasoybean-2 farmers received higher return on their investment

Skeletal muscle metastases are an exceptional mode of revelation of broncho-pulmonary cancers, we report a case of a patient with lung cancer disclosed by skeletal muscle metastasis. The patient consulted for a painful mass of the left calf with significant weight loss, the medical imagery shows an intramuscular process and the ultrasonography guided biopsy shows an infiltration of the muscle with metastatic adenocarcinoma, immunohistochemical patterns suggested the pulmonary origin, the treatment included muscle resection and chemotherapy. Skeletal muscles metastases from lung cancer are rare and although indicative of a poor prognosis, the treatment is poorly codified and differs from case to case.

Gender based violence is rising. Bangladesh stands second in the world in terms of violence against women in different forms like women battering, wife beating, domestic and dowry-related violence, acid attack, rape, physical and verbal harassment, fatwa, sexual harassment in the workplace, trafficking and prostitution, polygamy and child abuse. The rate of violence against women has dropped by 4.9 percent in between the years 2011 and 2015. Abusing rate was 87.1 per cent in 2011 which came down to 82.2 percent in 2015 and in the Daily Star newspaper came down to 80 percent in 2016. Around 72.6 per cent of women who are married in Bangladesh experience one or more such forms of violence it the hands of their husbands at least once during their marriage and 49.6 percent of lifelong married women suffered physical violence, 28.7 percent emotional violence, 27.2 percent sexual violence and 11.4 percent financial violence according to the Bangladesh Bureau of Statistics. Gender discrimination also leads to women having less opportunity. The literacy rate for women in Bangladesh is only 43.2%, while 61.0% of Bangladeshi men are literate. The unemployment rate for women is 70.7%, much higher than the 12.4% unemployment rate for men. Most of the victims, around 39.7 percent, of forced or coerced sexual intercourse, are aged between 15 and 19. Child marriage that legitimizes sexual abuse of minors must be stopped immediately. The government should enhance legal and criminal justice systems to prevent further violence and need interventions to change male attitudes.

PLMA is a recent, complex, and ingenious development with some added features of Classic LMA like Modified dual cuff ,Drain tube, positive pressure ventilation at higher peak inspiratory pressure. Study was to evaluate and compare the use of Proseal laryngeal mask airway and endotracheal tube with controlled ventilation in patients undergoing gynecological laparoscopic procedure. 100 patients, ASA risk I & II, posted for elective laparoscopic were recruited in the study. All the patients between 18 to 45 yrs of age were randomly divided in two groups Group PLMA and Group ETT (50 patients each). Attempt of insertion of airway device, Leak pressure, pulmonary ventilation, Hemodynamic; heart & MAP, gastric distention were recorded. All patients were of middle age group, comparable in weight. Mean duration of laparoscopy was comparable in both the groups. Significant rise in heart rate and mean arterial pressure seen in group ETT after induction of anesthesia .Changes in the end tidal CO2 and peak airway pressure after induction of anesthesia, before & after peumoperitoneum were comparable in two groups. After head low position peak airway pressure is slightly raised in Group PLMA. Gastric distension was noted higher in Group PLMA (8%).Incidence of sore throat (22%), nausea vomiting (14) airway trauma (14%) was higher in group ETT. Hemodynamic stability was better in PLMA group at time of induction and comparable in two groups at time of pneumoperitoneum and trendelenburg position along with pulmonary ventilation. Post operative sore throat, nausea vomiting was higher with endotracheal tube.

Thyroid diseases are among the commonest endocrine disorders. Hypothyroidism is an insidious condition in which the thyroid gland does not synthesize enough thyroid hormones to meet metabolic requirement of the body which is associated with subtle and nonspecific symptoms with significant morbidity. Hypothyroidism is the leading cause of several complications the commonest being overweight and obesity. The present study was undertaken to evaluate the BMI at the time of diagnosis in hypothyroid patients and compare with that of normal individuals. A comparative study was conducted, 100 cases of hypothyroidism at the time of diagnosis and 100 controls in the age group of 20-40 years, both Males and Females. BMI was calculated, data of T3, T4 & TSH levels were collected & compared between normal and hypothyroid subjects. It was found that hypothyroid subjects had a higher body mass index than the normal individuals. Hence maintenance of thyroid hormones at normal level and regular monitoring of BMI in Hypothyroid patients will help in early detection and prevention of Obesity and its related complications in future.

The choroidal macular neovascularisation (NVC) of the young subject is a serious condition that threatens visual function. The decrease in marked visual acuity is related to the foveolar or juxta-foveolar localization of the neovessels. The therapeutic management of idiopathic NVC of the young subject is difficult due to frequent recurrences despite the treatment. The use of anti-VEGF (vascular endothelial growth factor) represented a turning point in the management of this condition. The intravitreal (IVT) injection of bevacizumab appears to be effective and well tolerated.

The basic aim of our study was to develop and evaluate the polyherbal soap by using different extracts (extracts of neem leaves, papaya leaves, aloe leaves, turmeric and tulsi leaves) having greater antioxidant and antimicrobial potential. Pre-eminently, basic soap was prepared using Coconut oil and NaOH (lye) and the different extracts were incorporated into the basic saponification reaction. The herbal formulation thus prepared was then consigned for the evaluation testing for the analysis of pH, Moisture content, foaming ability, foam retention time, saponification, Total Fatty Matter determination and antimicrobial activity. The results demonstrated that pH 7.5 – 8, moisture contents 8.6%, foam retention time 1.20 minutes, Saponification value was 210.375 mg/ml, 30% TFM for polyherbal soap. Also the evaluation tests showed that the poly herbal soap has satisfactory antimicrobial results as compared to standard antibiotic. Some human infections which are majorly caused due to wounds, acne or blisters; these strains of microorganisms are of greater benefit. Moreover, oils and extracts used are added to treat various skin infections and are perfect for daily usage.