Heart failure is the end stage of all diseases of the heart and is a major morbidity and mortality. Unfortunately, heart failure may be difficult to diagnose clinically, as many features of the condition are nonspecific. The overall incidence is likely to increase in the future because of both an aging population and therapeutic advances in the management of acute myocardial infarction leading to improved survival in patients with impaired cardiac function. Aim: the various clinical manifestations of Chronic Heart Failure and to identify the major etiological and risk factors of Chronic Heart Failure. Methods: This study was conducted in the Department of General Medicine and Cardiology, Prathima Institute of Medical Sciences, Naganoor, Karimnagar. Institutional Ethical committee Permission was obtained for the study. A total of 50 patients with symptoms of heart failure were included in the study. All patients selected were subjected to detailed history, clinical examination and investigations. Complete Hemogram, Serum electrolytes - Sodium, Potassium, Calcium, and Magnesium, Blood glucose levels, Renal function tests, Chest X-Ray, ECG, 2D ECHO, Serum fasting lipid profile, BUN, serum uric acid, Liver function tests, and complete urine analysis. Results: The most common sign on examination was pulmonary rales in 34(68%). Next was S3on auscultation in 31patients (62%), B/L ankle edema was noticed in 29 patients (58%), raised JVP in 24 (48%), tachycardia HR >120 bpm was noticed in 16 (32%), tachypnea RR >30 was seen in 19 patients (38%). Diabetes was noticed in 9 patients, five of them had and two were having previous h/o of IHD. Broad QRS complexes >120 msec was noticed in 12 patients (24%) had complete LBBB with very broad QRS complexes >140 msec. ...

Abstract: Polyhydramnios is an important obstetric complication with increased maternal morbidity. Undoubtedly, ultrasound is the best means to diagnose polyhydramnios USG has revolutionized the process of assessment of amniotic fluid thus becoming an integral part of fetal surveillance. In a low resource health facility as India with poor coverage of antenatal care and malnutrition it still becomes more important to screen pregnancies for such high risk factors. To determine the incidence and to assess the maternal outcome in patients diagnosed to have polyhydramnios in singleton pregnancies. The present study was conducted in Guahati Medical College for a period of one year from July 2017 to June 2018. All the patients were identified as having polyhydramnios using Largest pocket diameter method. The incidence of polyhydramnios in singleton pregnancy during the study period was 1.04 %. Majority of cases (76.61%) were mild, 14.03% moderate and 9.36 % severe polyhydramnios. Most common etiology was found to be idiopathic 69% followed by congenital anomalies19.8% and Diabetes Mellitus 10.52% Out of 171cases, 9 case was an abortion out of which 8 was induced due to fetal anomaly, 37 cases had preterm vaginal deliveries, 59 cases had full term vaginal deliveries, 66 cases had cesarean section. The most common maternal complication encountered was preterm labour and the most common malpresentations was breech. The study gives us the understanding of the impact of polyhydramnios on maternal outcome.

The present article investigated the previous body of research on trust in business negotiation, providing an extensive literature review on the subject. This study is helpful to students, practitioners, academics, managers, business negotiators, mediators, and other professionals in general, stimulating the reflection on their social and workplace business negotiation behaviors, as well as deepen the underlying process of self-awareness and thus provide an opportunity self-learning, behavior changes, and development, on business negotiations trust matter. This article investigated the following theoretical approaches: (a) Behavioral; (b) Psychological approach, encompassing: (b.1) unidimensional; (b.2) two-dimensional, and (b.3) transformational approaches, as well as the fundamental supportive theories to trust regarding the business negotiation process. This literature review is part of my doctoral thesis and aims at providing consolidated information on the subject Trust in Negotiation for academics, practitioners, and students in general, as well as presenting the newly theoretical academic contribution, the transformational Compelled-Based Trust Approach. Discussion and future research recommendations complete the present work

The objective of this study was to reveal the effects of opportunity, internal control, and management commitment on fraud opportunities. The samples were taken at some companies in Palembang, including PT. PLN UIP Sumbagsel, PT. PLN WS2JB, PT. Surveyor Indonesia and the Regional Mining and Energy Company totalling 154 respondents. Out of 154 questionnaires sent, 148 questionnaires were returned. The sampling was done using the purposive sampling technique. The data collected were the primary data which were first tested for their validity and reliability. The data analysis method used was the multiple regression analysis that had met the classical assumption testing requirements. The results of the study indicate that the opportunities have a significant effect on the fraudulent actions in the selected companies. Whereas the internal control and the management commitment have a negative effect on the fraudulent actions

Allopurinol is a drug indicated for the treatment of hyperuricemia. Its hepatic toxicity is rare. This is a case report about acute cytolytic hepatitis caused by allopurinol in a 62-year-old.

Proper reactive power management for improving the a.c power system performance always result in loss minimization. It is all about the supply of reactive power in a transmission line to increase the transmittable power thereby making it compatible with the prevailing load demand. In this paper, various factors contributing to loss minimization in a.c networks were examined, and include the use of: shunt capacitors and reactors, synchronous capacitors, tap changing transformers, series capacitors e.t.c. Recommendations to minimize losses in the system were proffered in this study to ensure good power quality and security in the network.

Abstract: Pre-eclampsia, is an obstetric disorder characterized by hypertension and proteinuria that prevails all over the world. It presents as a pressing peril for fetal and maternal lives. Though inflammation, increased levels of TXA2, ischemic placenta, dysfunction of endothelium are discerned, the exact pathophysiology yet remains a mystery. The absolute treatment is still to be discovered, however its prevention by low dose aspirin and calcium supplementation present as promising preventative measures for pre-eclampsia. To observe the effect of aspirin and calcium in prevention of preeclampsia. This was a prospective clinical trial study for evaluation of role of aspirin and calcium in prevention of pre-eclampsia in primigravidas. It was carried out at department of Obstetrics and Gynecology at AL-Wahda hospital Derna from Jan 2016 to Dec 2016. Three hundred and forty four primigravidae were included in the study. Their age ranged from 16 to 45 years with a mean 26.32 ± 4.88 years. Out of the 344 healthy primigravidae, 63 (18.3 %) developed preeclampsia. Both (aspirin and calcium) supplementations were associated with a reduction preeclampsia. There was significant difference between the group taken both (aspirin & calcium) group and prevent pre-eclampsia (X2= 6.07, P= 0.014). In Conclusion, It was noted in the present study that low dose aspirin and calcium might have beneficial effect in the prevention of preeclampsia.

Workplace turnover is destructive to nursing and patient outcomes as it leads to losing competent and qualified nurses. However, developments of coping strategies demand a clear understanding of workplace variables that either motivates nurses to remain employed or lead them to leave their current jobs. This study assessed the relationship between socio-demographic characteristics of members of nursing staff and their job satisfaction as well as perceived factors influencing turnover among nurses in Ahmadu Bello University Teaching Hospital Zaria, Nigeria. Cross-sectional study design was carried out on 304 nurses using quantitative data collection methods from 8th April, 2016 – 22nd April, 2016. The respondent’s age ranged between 20-63 years with a mean age of 39±10.97 years. Age, gender, marital status; and job satisfaction yielded a nonstatistical significant, weak and positive correlation with job satisfaction. Number of years worked, professional experience and unit of primary assignment were the only sociodemographic characteristics found to be significant predictors of job satisfaction in ABUTH (P < 0.05). Insufficient cohesion with colleagues, poor safety of the work environment; undervalued nurse’s opinion by medical staff and poor professional image of nursing were identified as perceived factors positively influencing nurse’s intension to leave the hospital. The study suggests that nurses’ opinion should be respected by other professionals and nurses professional practice judgement should not be relegated on the bases of sentiments.

The property of iron to get reversibly oxidized and reduced is essential for its metabolic functions. Severe iron deficiency can produce cardiovascular disease. Wide range of biochemical markers are implicated in the pathogenesis of anaemia like Serum Ferritin, Malondialdehyde and Homocysteine. The purpose of the study is to assess serum ferritin, homocysteine and plasma malondialdehyde levels in Iron deficiency anaemic patients and to find whether anaemic patients are prone to cardiovascular disease or not. A case control study was carried out at Lata Mangeshkar hospital, Nagpur in which serum malondialdehyde and homocysteine levels measured in 30 diagnosed patients of Iron deficiency anaemia in the age from 19 to 40 years were compared with healthy controls. Malondialdehyde was estimated by the method of Randox laboratory. Serum homocysteine was measured by using ELISA kits. The data was analysed for correlation between levels of homocysteine and malondialdehyde with serum ferritin in patients of Iron deficiency anaemia. Serum malondialdehyde levels in patients with Iron deficiency anaemia were higher i.e. 0.680+0.349 (ng/ml) than in controls which were 0.144+0.102 (ng/ml) with a statistically significant value of p <0.05.Statistically, there was also a significant rise in homocysteine levels in patients with Iron deficiency anaemia i.e.76.105+16.836(ng/ml) as compared to 27.57+12.11 (ng/ml) in controls. An inverse relation exists between serum ferritin and markers of oxidative stress. Iron deficiency anaemic patients have elevated levels of malondialdehyde and homocysteine than the control group and both these parameters may be common mediators in the pathogenesis of accelerated atherosclerosis.

Systemically reviewing the topic Mandibular Third Molar Impaction and its components: prevalence, causes, classifications, complications, and managements. All studies pertaining to the topic and its components were included. Exclusion criteria were applied to exclude studies that were not PubMed indexed. The materials and methods used for this systemic review were to search in the PubMed database, using specific words "Mandibular Third Molar Impaction, Prevalence, Causes, Classifications, Complications, and Managements” and published in the English language. The articles were reviewed, 25 papers were identified in PubMed but a total of 20 papers were included in the final systemic review according to the specific keywords and materials mentioned above. The occurrence of Mandibular Third Molar Impaction can be seen in everyday routine oral surgery practice. The prevalence of Mandibular Third Molar Impaction is remarkable but varied from one study to another. Causes were investigated showing a multifactorial tendency. Classifications are very essential for diagnosing different types of impaction. Diverse Complications related to Mandibular Third Molar Impaction are possible, yet avoidable. Management was reviewed showing a verity of treatment modalities.

Abstract: Caesarean scar Pregnancy (CSP) implanted in the caesarean section scar is a rare location among ectopic pregnancies that can be life-threatening. It can be classified at the same level of gravity as the placenta accreta. Hysterectomy is the gold standard treatment for massive bleeding. The diagnosis of pregnancy implanted in the caesarean section scar is a difficult diagnosis of the first trimester. It must be done as early as possible. Clinical manifestations are not specific, bleeding and pain is the most common symptoms. Endovaginal and pelvic ultrasound associated with Doppler is the first-line examination, provides optimal and panoramic vision, and studies reports of the gestational sac and its vasculature. Recent studies report the value of MRI in diagnosis because of its affinity for the study of pelvic tissue and the relationship of structures. The treatment remains non-consensual but it appears that the injection of methotrexate in situ by preferring the vaginal route is effective and not very morbid. We present here the case of a patient with CSP whose diagnosis was initially unknown.

The translation of English for science and technology (abbreviation for EST) in the internet era caters to the needs of the market and boasts a promising prospect. EST is a kind of informational text characterized by its scientific seriousness, requiring the translator to demonstrate the accuracy and logicality in translated text. Results show that the figure-ground theory can be well applied to spatial orientation analysis, temporal event analysis, and syntactic analysis. Regarding the complex sentences, Tamly put forward five principles of figure-ground theory including sequence principle, cause-result principle, inclusion principle, contingency principle and substitution principle. Taking petroleum EST as the research object, this paper applies the five related principles to the syntactic analysis of long and complex sentences with examples.

Iron craft is a society cultural heritage that has to be preserved. There are many factors working on the sustainability of domestic iron craft industry. This research aims to investigate those factors. The primary data were collected through the field observation, deep interviews, surveys, and documentation. The secondary data were obtained from literature reviews. Those data were deeply analized by qualitative method. The result of this research reveals some factors obstracting the rise of iron craft productivity which are human resourses, management, and finishing. The decreasing number of labors working in this industry and the absence of potential future Iron craftmen as well as the inadequate tecnology application to do the finishing process. Good management practise is required to develop the iron craft business. The values believed by the blacksmiths are family values, community values, and cultural values. The trade off of technology application replacing the labors potentially decrease the current values. On the other hand, technology is requaired to increase the productivity.

The prosthetic considerations for treatment of partially edentulous patients involve evaluation of important aspects such as presence of certain functional or skeletal deficits, orientation of the occlusal plane, free-way space, size and location of edentulous areas, number, strategic location and quality of the likely abutment teeth, vertical dimension, and the type of occlusion. A comprehensive evaluation, multidisciplinary approach and a sequential treatment plan, worked out in harmony with the patient’s perceptions are important factors to ensure a successful outcome. One of the major conditions faced for full mouth rehabilitation is the severely worn dentition. In the present era with increased life expectancy, improved dental care, increased retention of teeth and increased awareness about oral health number of patients with generalized worn dentition have increased. This case report presents a case of partially edentulous bilateral jaws in which full mouth rehabilitation was done using implants and tooth supported prosthesis.

Infertility has remained a major health problem among couples and sexually active individuals who seek to procreate, and the search for therapeutic solutions have remained endless. This led to the consumption of moringa oleifera as fertility aid. Therefore, this study investigated the effects of ethanolic extract of moringa oleifera seeds and leaves on pregnancy. Eighty-four (84) albino rats comparing of 56 females and 28 males, which acclimatised for two weeks and mated in ratio of 2 females to 1 male, the pregnant female rats were then divided into 7 Groups of 7; All rats were weighed on a daily basis throughout the research period. Group 1- Control (10ml/kg body weight/day of vehicle [Tween 80] orally). Groups 2-4 (Seed extract at dose level of 100, 200 and 400mg/kg body weight/day respectively), Groups 5-7 (Seed extract at dose level of 100, 200 and 400mg/kg body weight/day respectively). Administration was carried out throughout the gestation period. The blood samples were collected for hormonal assay and under standard aesthetic conditions. From the results it was observed that the moringa oleifera leave and seed extract caused resorption of the foetus with decrease in weight in a dose dependent manner; however, there was no disruption of the normal gestation. The levels of FSH and LH for animals treated with 400mg/kg were significantly lower than those of 200mg/kg, 100mg/kg and the control group. In conclusion, the ethanol extract of both the leaf and seed of moringa oleifera has shown abortifacient effect and therefore not advise for consumption during pregnancy.