The aim of the study was to study effectiveness of inhalation sevoflurane with the laryngeal mask airway (LMA) in children undergoing surgeries below umbilicus. Thirty premedicated children 3-12 years old with the American Society of Anaesthesiologists physical status of I to II were enrolled and received induction with sevoflurane 7% by face mask and maintained with 50% oxygen and 50% nitrous oxide mixture followed by 1.7% sevoflurane with LMA. Demographic data, induction time, number of attempts, LMA insertion, removal and recovery times, haemodynamic parameters, complications, Aldrete score and child’s behaviour score were recorded. LMA insertion was successful at the first attempt in 93% with sevoflurane. LMA insertion, removal and recovery times were (1.26±0.36, 2.76±0.51, 5.16±1.6 minutes respectively). Perioperative minor complications were there. Recovery milestones including Aldrete score in the group was (9.03) t 5 minutes and comparable at 15 and 30 minutes. There was a greater incidence of excitatory phenomena with sevoflurane. Haemodynamics were studied. Sevoflurane provided short LMA insertion, removal and recovery times in children undergoing minor surgeries below umbilicus with little perioperative complications. Agitation was seen with sevoflurane.

This study seeks to contribute to the ongoing investigation on the growth effect of foreign direct investment in Nigeria. The study utilized annual time series data for the period 1981-2016 and the OLS estimation technique. Apart from the long-run estimation, the study also captured the short-run dynamics using an error correction model. The findings show that the role of FDI remained muted both in the long-run and short-run. However, the study established that growth in gross fixed capital formation and the dynamics of the naira to U.S. dollar exchange rate play important roles in economic growth in Nigeria, at least in the long-run. The study therefore concludes that there is need for Nigerian government to evolve and implement policies that can drive the inflow of foreign direct investments into the productive sectors of the economy in order to enhance the productive capacity of the economy. Such policies should encourage a stable economic and political environment that will enhance the confidence in foreign investors in the domestic economy

The repair of eyelid needs a good knowledge of reconstruction techniques. The goal of this work is to study epidemiological and technical aspects of eyelid defects in our context, and to evaluate their functional and aesthetic repair. We report cases concerned by loss of eyelid tissue operated between September 2011 and September 2016. Epidemiological, clinical and histo-pathological aspects are described, the repair processes and various surgical techniques are discussed. Among the identified cases of eyelid defects, 74% were malignant tumoral pathology, while 26% were benign. The repair techniques used were suture, direct healing, skin graft, flap of Mustardé with mucous chondro graft, frontal flap and sub-mental flap. The eyelid defects need functional and aesthetic valid repair, the various reconstruction means should begin from the simple ones to more complex.

Spinal trauma is very common in orthopedic practice. There is a debate as to whether the surgical or conservative approach is more effective in the treatment of spine fractures. We in the present study tried to evaluate the outcomes of patients with spinal fractures treated with the conservative treatment and surgical treatment and overall outcome of treatment in the patients. Methods: In this prospective cross-sectional study conducted in the Department of orthopedics, MGM hospital attached to Kakatiya Medical College. A total of 30 patients were included in the study of which (n=15) patients were treated with conservative treatment based on the presentation of fractures and similarly (n=15) were taken for operative treatment depending on the type of fractures. A Detailed history of the injury was obtained they were clinically and radiologically evaluated for the thoracolumbar fracture. The radiographs included the anteroposterior and lateral views. Laboratory investigations were carried out before the surgery. CT and MRI scans were carried out to evaluate the relationship and instability of the spine. Results: The L1 vertebra was the most common to get fractured and most of the fractures (74%) were appeared at T12 and L1. AO type, A fractures were only studied with the majority of the fractures (66.6) were falling into AO type A3 (burst fractures). DENIS pain scale scores in conservative treatment, category 8 (53.3%) of patients were in the P3 category similarly in operative treatment 46.67 % of patients were in P1 category...

Mental health disorder is one of the major health problems, which requires early & effective treatment. WHO global burden of disease 2001 estimates four main psychiatric causes leading to disability, which is Depression, Alcohol abuse, Schizophrenia & Bipolar disorder. Although current psychotropic medicines have remarkable effect on mental illnesses, their utilization in clinical practice needs to be done regularly hence, current study aims to observe the utilization and prescribing pattern of various drugs used in department of psychiatry, according to various WHO drug use indicators. It is a prescription based prospective, observational study conducted on 1200 prescriptions of patients attending department of psychiatry for 18 months. Total of 3632 drugs were prescribed in 1200 prescriptions analyzed, where 48.4% (581) were males and 51.6% (619) were females, majority of the patients 56.25% (675) belonged to age group of 21-40yr, 85.67% (1028) individuals were married. Out of total drugs prescribed 2971 (81.80%) were psychotropic drugs. Average no. of total drugs & psychotropic drugs prescribed per encounter was 3.03 & 2.48 respectively. 1680 (46.26%) drugs were prescribed from the WHO EDL formulary (2016), all the drugs were prescribed by brand names, percentage of prescriptions with injectable drugs accounted for 4.75%. Polytherapy (>5drugs) was observed only in few prescriptions 26 (2.17%). This study advocated an overall rational utilization of psychotropic drugs with fewer deviations due to the prescription practices of healthcare providers, which needs an improvement, to ensure rational use of drugs.

Induced labour is one in which pregnancy is terminated artificially, any time after foetal viability is attained, by a method that aims to secure vaginal delivery. At term, upto 15 – 30% of pregnancies in obstetrics practice are induced for labour due to various foetal and maternal indications. Dinoprostone (Prostaglandin E2 or PGE2) has been shown to be the most effective agent achieving for cervical ripening. The present study is conducted with an aim of comparison between the two preparations i.e. dinoprostone vaginal gel vs dinoprostone vaginal pessary administration in a pregnant women with singleton pregnancy with vertex presentation for efficacy and safety in induction of labour. This tertiary level hospital base prospective observational study is done on 100 pregnant women out of which 50 pregnant women were given dinoprostone vaginal gel and 50 pregnant women were given dinoprostone vaginal pessary after obtaining informed consent. Data were collected on number of doses of drug required for delivery (58% required single dose in gel group vs 80% required single dose in pessary group), need of oxytocin augmentation for delivery (56% in gel group vs 30% in pessary group), induction to delivery interval (Mean 20.86 Hrs in gel group vs 16.88 Hrs in pessary group), mode of delivery (Vaginal delivery 46% in gel group vs 80% in pessary group), maternal complication (84% in gel group vs 90% in pessary group with no complication) for maternal outcome and for foetal outcome liquor characteristic (72% in gel group vs 88% in pessary group with clear liquor) and NICU admission (12% in gel group vs 6% in pessary group). Dinoprostone vaginal pessary is more effective for cervical ripening in induction of labour then dinoprostone vaginal gel

Aim of this work was to compare properties of two etching gels produce by Kerr Orange and Spofa Dental. Etching gel are water solution of phosphoric acid using in total etch techniques. They are applicable on enamel surface for 30 seconds to make partially dissolving of hydroxyapatite crystals and increase mechanical adhesion between bonding agents and tooth structure. Materials and methods two commercial phosphoric acid gels (Kerr and Spofa Dental) were tested in consistency, thixotropic properties, water disintegration, force necessary for extrusion material from syringe, fil thickness. Results: Kerr materials has higher consistency, is less thixotropic compare to Spofa product, has longer time to dissolve (18 min), lower force necessary to extrusion 5 N and film thickness 4 microns. Conclusion: On the market exist etching gel based on different gelling agent organic gums or fumed silicas. Some clinician prefer material with higher viscosity for some application, other groups of practicing doctors are using less viscous materials.

In this paper, we compare the difference of non-monotone strategies to solve the wedge trust region method for derivative-free optimization. The wedge trust region method based on traditional trust region which is designed for derivative-free problems. Considering the effectiveness of the non-monotone strategy compared with monotone ones, we combined the non-monotone strategy into wedge trust region methods. The computational results show that the both two strategies have their respective advantages.

According to IDF diabetic atlas 8th edition, south –East Asian region is the 2nd highest of all IDF regions. It was estimated that. It was estimated that by 2040, this will raise to 150 million 69.1 million adults are diabetic in India according to 2015 census. Material and Methods: For every 11 persons 1 is diabetic. 1 child in every 6 births is affected by hyperglycemia in pregnancy. 2/3rd of people with diabetes is living in urban area and belongs to working age group. 1 in every 2 persons is undiagnosed. To motivate the youngsters to lead a healthy life style and create awareness about the risk of developing diabetes due to lifestyle modifications. Results: Questionnaire based study among 100 medical students further evaluation of blood glucose levels among the high risk group. We have identified that the lack of exercise was the main risk factor among the study group. There is a lack of physical activity among medical students of the study group.

Turnover Intention is the desire of the merchant to quit his job. The purpose of this study is to determine the direct influence of independent variables of leadership, compensation and workload of the dependent variable is turnover intention. This research was conducted at PT Karya Utama Perdana, with 113 respondents from total population of 162 employees. In determining the sample of this study, the authors use the formula slovin and data collection is done through interviews and questionnaires. Then on the data analysis, the authors used multiple linear regression analysis techniques that were processed using SPSS software version 24, so the results obtained further indicate that leadership has significant effect on turnover intention, compensation has no effect and not significant to turnover intention, and workload significantly influence to turnover intention.

Blood transfusion is a routine, life-saving medical intervention which is generally regarded as safe when done appropriately, but it is not absolutely free from adverse reaction. The aim of the study was to analyze the Adverse Transfusion Reaction (ATRs) as a part of Haemovigilance Programme of India at VIMSAR, Burla. This study was prospective and observational. All blood transfusions and adverse reaction which occurred due to transfusion at V S S Institute of Medical Science and Research (VIMSAR), Burla, between June 2018 and November 2018 were studied. The reactions were reported in a pre-designed transfusion reaction (TR) reporting form for blood and blood products as per the Haemovigilance software, PvPI. ATRs were also analyzed with respect to types of blood products. Total blood components issued by our blood bank to various departments and total ATRs during the study period were 13145 and 121 respectively. Majority of the reactions occurred with whole blood (0.71%), followed by packed red cells (0.17%). The most common ATR observed was allergy (80.16%) followed by febrile Non hemolytic TR (19.83%). Most of the ATRs were acute reactions. The study emphasizes the different reaction accompanied with blood transfusion, and how it can be minimised by proper laboratory technique so that quality and safety of transfusion therapy can be improvised.

This study critically examines the procurement Act 663, its impact on accountability and transparency of officers in the public sector. Specific research objectives were set to determine the laid down procedures for procurement Act; determine the competence of procurement staff in the procurement sector and to review the budgetary perspective of the procurement entity in Ghana. As methodology, the study adopted a quantitative research approach while employing a case study approach. Overall, 380 questionnaires were administered as well as face-to-face interviews conducted. The study findings revealed that the staff lacked professional knowledge on procurement service as the financial budget allocated for staff training was vastly inadequate. The study also revealed that a varied level of compliance existed among the procurement institute studied in respect of part II of the Act. It was also established that, whereas there was a high level of compliance in areas of well-established tender committees among significant others, prior mandatory days before scheduled date for meetings and professional expertise in procurement practice showed relatively low compliance. Furthermore, even though high education levels were indicated in the study; little was revealed about the acquisition of professional qualification in procurement among staff in the entity. The study recommends among others that an operational manual for procurement Act should be given to all procurement staff to guide and make them conversant with the procedures that guide procurement profession.

This study evaluated the tendency for Cocos nucifera juice to be effective in management of hepatic and renal anomalies in a human design. 180 male subjects were used for this study. With treatment A as the control, Cocos nucifera juice was administered in 3 doses; B, C, D-50ml, 100ml and 150ml respectively. The experimental period lasted for 42 days. The biochemical assay protocols were aimed at investigating changes relating to hepatorenal function. Biomarkers assayed for include aspartate transaminase, alanine transaminase and alkaline phosphatase for liver function biomarkers, creatinine, cystacin-3 and interleukin-18 for kidney function biomarkers. There was a dose dependent change in both liver and kidney function biomarkers. This study revealed an inverse relationship between Cocos nucifera juice ingestion and the serum level of these metabolic biomarkers. There was also a time dependent reduction as well as a progressive decrease in harmonic mean of the assayed biomarkers for all dose treatments. Cocos nucifera has the potential to be applied in the management of hepatic and renal dysfunction.

Cerebral sinus venous thrombosis is a very common condition and it is an important cause of stroke especially in the peripartum setting and is one of the common causes of stroke in young patients. The present study has been undertaken to describe the clinical profile, diagnosis, and prognosis of CSVT. Methods: This cross-sectional prospective observational study was conducted in the Department of General Medicine, Prathima Institute of Medical Sciences, Nagunoor, Karimnagar. Based on the diagnosis 50 patients were included in the study, meticulous history, clinical examination, laboratory investigations including complete blood count, ESR, RBS, serum urea, serum creatinine, LFT, serum electrolytes, Urine electrolytes, ECG, CSF analysis were done in addition to imagining of the brain. Results: Out of 50 patients 25(50%) belong to the puerperal group and 25 (50%) belong to a non-puerperal group. Out of 25 non-puerperal patients 5 were female and 20 were male patients. The 25 puerperal cases the CSVT was seen in 18 cases in the first 10 days post-parturition and 5 cases were between 11-20 days and 1 case each of 21 -30 days and > 30 days were seen. In the present study, 24 (48%) of CSVT had a sub-acute presentation followed by 18 cases (36%) with an acute presentation. The clinical signs were hemiparesis and papilledema in 20(40%) of cases and pallor in 16(32%) and dysphasia was in 9(18%) of cases. In the study out of 50 patients, 17 were anemic, accounting for 34% and the mortality was higher when the degree of anemia was severe. Anticoagulant therapy with subcutaneous LMWH in 33 cases and intravenous unfractionated heparin infusion in 17 cases and later changed to oral anticoagulants. 5 patients required decompressive craniotomy out of which 1 patient died. Additional treatment included antiepileptics in 33 patients and anti-edema measures in 38 patients. Conclusion: CSVT is not an uncommon condition. Clinical presentation is extremely varied and symptoms may evolve over hours to few weeks. Neuroimaging plays a pivotal role in diagnosis MRI with MRV is the current diagnostic modality of choice. Management with unfractionated heparin, LMWH, and oral anticoagulation is appropriate. Surgical decompression is helpful in the cases of continuing deterioration, in spite of maximum medical management

Complicated UTIs (cUTIs) are one of the leading causes of the gram negative bacteraemia which occur in patients who have a functionally, metabolically, or anatomically abnormal urinary tract. The primary objective of this study was to compare efficacy of Piperacillin/Tazobactam (PT) and Cefoperazone/Sulbactam (CPS) combinations in complicated Urinary Tract Infections. At entry, total 92 patients admitted in the hospital due to cUTI were enrolled. Among of 92 patients, 49 patients were given PT while 43 patients were given CPS combinations. Clinical symptoms were registered and scored as mild (1) moderate (2) or severe (3). The follow-up were done daily till the patient is discharged. Thereafter, one follow up visit was done within 4 to 9 days of after discharge, termed as test of cure (TOC). Furthermore, one late follow up visit after 6 to 8 weeks was done, known as late follow up visit (LFU). Clinical assessments and microbiological analysis were done at the time of TOC and LFU. The mean baseline clinical score for PT and CPS were 10.89 ± 2.23 and 10.28 ± 2.33, respectively. At TOC visit, PT and CPS groups, clinical scores were 0.86 + 2.35 and 1.36 ± 3.48, respectively; suggesting significant improvement from baseline (p< 0.001). Rate of clinical improvement at TOC visit was 92.68% and 87.50%, while microbiological cure rate was 87.80% and 93.75% with PT and CPS groups respectively. While, at LFU visit, clinical scores in PT and CPS groups were 1.32 + 3.37 and 1.65 + 3.56, respectively, suggesting significant improvement from baseline (p < 0.001). Clinical cure rate at LFU visit was 87.80% and 87.75% while microbiological cure rate at LFU visit was 82.92 and 77.00% in PT and CPS groups, respectively. These results suggest that both regimens have no significant difference for the treatment of cUTI. PT and CPS, both the combinations, are equally efficacious in treatment of cUTI.