Abstract: Fasting for at least eight hours prior to a lipid test has been standard practice in India and internationally for many years. However, a growing body of evidence and international expert opinion suggests that a non-fasting lipid profile can be used in most situations. Factors That Contribute to an Individual’s Usual Cholesterol Level: The National Cholesterol Education Program (NCEP) has the following recommendations to ensure that individual lipid measurements are clinically useful. Individuals should be on their regular diet and their weight should be stable for at least 2 weeks before their lipids or lipoproteins are measured. Patient preparation and blood collection procedures should be standardized according to these guidelines: Variation in lipid values- Age and gender, Posture, Venous Occlusion, Anticoagulants. Prolonged tourniquet application (2–5 min) can increase cholesterol from 5 to 15%. Biological variation is <5% for cholesterol, LDL cholesterol, and HDL cholesterol and 20 to 30% for triglycerides, Considerable variation can occur from one assay to another between clinical laboratories, For patient care, it is important to know if the LDL is calculated or is measured directly, In order to compare results from different laboratories, it is important to know which assay method is utilized, If patient is non-fasting, a direct LDL test is recommended, Sudden changes in lipid values may indicate a change in diet, medications, or onset of a new disease state. When attempting to answer whether fasting or non fasting lipids are most appropriate, it is important to first think carefully about the clinical scenario and consider what question is to be answered with the results.

This study aims to analyze the accountability process of the performance of government officials in the service of electronic Resident Identity Card (e-KTP) in Bantaeng Regency and analyze aspects that affect the accountability of the performance of government officials in the service of E-KTP in Bantaeng Regency. This research was carried out in Bantaeng Regency using qualitative approach, which is a method that has several theoretical perspectives with the type of case study. The research shows that the accountability of the performance of local government apparatus in e-KTP service at the Bantaeng Regency Population and Civil Registration Service still needs to be improved if it refers to several accountability indicators namely legal accountability and honesty, process accountability, program accountability, and policy accountability of the four indicators, indicators of local government must be able to improve the quality of the performance of the apparatus, especially from aspects of the process and program, although on the other hand there are some obstacles to the apparatus in carrying out their duties, functions and authority from these indicators. Indicators of legal accountability and honesty as well as policy accountability have run quite well, but these advantages must always be maintained in order to provide maximum service to the people of Bantaeng Regency.

Abstract: Some meat and dairy products contain small amounts of naturally occurring trans fat. But most trans fat is formed through an industrial process that adds hydrogen to vegetable oil, which causes the oil to become solid at room temperature. This partially hydrogenated oil is less likely to spoil, so foods made with it have a longer shelf life. Some restaurants use partially hydrogenated vegetable oil in their deep fryers, because it doesn't have to be changed as often as do other oils. High intakes of industrial trans fatty acids (iTFA) increase circulating low density lipoprotein cholesterol (LDL-C) levels, which has implicated iTFA in coronary heart disease (CHD) risk. Published data on iTFA and LDL-C, however, represent higher intake levels than the U.S. population currently consume. Number of studies is under process. Findings indicated that a wide range of oils and interventions were used, limiting the ability to determine an isolated effect of iTFA intake. Further, it appears that few dose-response data points are available to assess the relationship of low levels of iTFA, particularly from PHO exposure, and LDL-C. Therefore, limited evidence is available to determine the effect of iTFA at current consumption levels on CHD risk.

Indonesia is one of the countries with a large number of corruption cases. Criminal acts of corruption in Indonesia have been pervasive and have entered into all walks of life. Its development continues to increase from year to year, in the number of cases that occur and the amount of state financial losses and regarding the quality of criminal acts of corruption carried out more systematically that has entered aspects of community life. Increased uncontrolled corruption will bring impacts that are not only limited to the life of the national economy but also to the life of the nation and state in general. This study uses a normative and empirical juridical approach. Normative research is carried out on the theoretical matters of legal principles relating to law enforcement in the case of corruption in Indonesia. This research method uses several approaches to produce a reasonable conclusion. The strategy of prosecuting policies in certain crimes must pay attention to the nature of the problem. If the nature of the problem is more on economic or trade issues, it should take precedence over sanctions for action and/or fines. The formulation of sanctions between Article 2 and Article 3 of this Law is contrary to the general provisions concerning sanctions regulated in the Criminal Code. In the Criminal Code determines if an act is carried out because of position and violates the authority. It is a criminal weight, while in this law in Article 3 which is an act as stipulated in Article 2 but carried out by misusing the authority, opportunity or means that exists because of the position or position but the threat is lighter than in Article 2. If the special law makes a particular minimum criminal threat, then it must be accompanied by rules/guidelines for its application such as comparative problems between specific minimums and maximal in particular. There should be a unique pattern that should be followed in other Article formulations. For example in Article 2 paragraph (1) the comparison is 1: 4 while in Article 3 the comparison is 1:20. There should be a similar pattern applied in each Article in the formulation of specific minimum provisions.

Ileal perforation is a common complication of Typhoid in developing countries other causes includes tuberculosis, trauma, and enteritis. Non-traumatic perforation is a challenge for surgeons because of considerable morbidity and mortality. This study tried to evaluate the etiology and clinical outcomes of surgical management for all the cases of non-traumatic ileal perforation. This prospective cross-sectional study was conducted in the Department of General Surgery, Prathima Institute of Medical Sciences, Naganoor, Karimnagar. Inclusion criteria were all the patients above 15 years undergoing surgery for ileal perforation. Excluded patients were those with appendicular perforations, peritonitis, and traumatic perforations. Based on the inclusion and exclusion criteria of 21 male and 17 female patients were included in the study. A thorough clinical examination of the patient including vital signs, abdominal distension, guarding and tenderness was done and noted. The laboratory investigations included Hemoglobin, BT & CT, and serum creatinine. Chest X rays, ECG, Blood culture and WIDAL tests were done to diagnose patients with typhoid. Results: In the present study out of 22 male patients 17 were diagnosed with typhoid perforation and 5 were a non-specific perforation. In the 17 females, 15 were diagnosed with typhoid perforation and 2 were non-specific perforations. The surgical approach for the management included primary closure in the total of 25 (64.10%) male and female patients followed by Ileostomy in 8 (20.51%), Ileo Transverse Anastomosis in 4 (10.26%) and resection anastomosis in 2 (5.12%) of cases. Conclusion: Within the limitations of the present study it can be concluded that typhoid ileal perforations are common in the group of patients reaching our hospital. The operative treatment for intestinal perforations should be based on several factors including operative findings. Early surgery with skilled surgeons and good postoperative care will result in reduced morbidity and mortality.

Part-time students are distracted by too many competing demands on their time because of work or family commitments. As a result they are not as involved as other students. This is problematic because what students gain from their college experience depends a lot on how much time and effort students put into their educationally purposeful activities. This study sought to find out challenges encountered by part-time students in selected public universities in Kenya. The study was based on student engagement theory. Data was collected from part-time students, games tutors, deans of students, officials of clubs and societies. Simple random sampling was used to select students while purposeful sampling was used to select games tutors, deans of students and officials of clubs and societies. Data was collected using questionnaires, focus group discussions and interview schedules. The analysis of the qualitative data followed the path of aggregating the words or images into categories of information and presented the diversity of ideas gathered during data collection. The study established that majority of the part-time students lacked time to participate in social activities in the universities. They spent most of their time travelling or looking for means of transport. The study further established that part-time students lacked information on the social activities in the university that they could participate in. It is hoped that the findings of the study will be useful to university management in understanding the part-time students’ social needs and satisfaction predictors so as to keep part-time students more engaged with their academic work and perform well in their examinations.

Sickle cell disease is a chronic, inherited disorder. Complications from SCD place patients at risk for poor psychosocial adaptation, including symptoms of depression anxiety and stress. To measure the prevalence of depression, anxiety and stress in adults with sickle cell anemia in the Kingdom of Bahrain, and to study the factors related to the development of depression, anxiety and stress in these patients, we did a cross-sectional study that involved administering Depression Anxiety Stress Scales (DASS-21). A total number of 343 patients above 18 years, with sickle cell disease were recruited by convenient sampling from Salmaniya medical complex, health centers and sickle cell disease society. Participants also completed a survey of demographic data with specific inquiries about common sickle cell anemia risk factors and complications. From 343 participants (199 males &144 females) 53.9% were depressed, 70.8% had anxiety and 51.6% were stressed. A significant association was seen for depression and female gender(p-value 0.041), lower educational level (p-value 0.005), unemployment (p-value 0.01), number of emergency visits (p-value 0.008), hospital admissions (p-value 0.005) and medications like anti-depressants (p-value <0.001). Similarly, anxiety was significantly associated with female gender (p-value 0.031), unemployment (p-value 0.017), hospital admissions (p-value 0.047) and medications (like MST, codalgin and anxiolytics). Stress, however, was not found to be associated with any of the socio-demographic factors but was significantly associated with number of emergency visits (p-value 0.001), hospital admissions (p-value 0.008) and medications (like MST, codalgin and anxiolytics). We found the prevalence of depression to be (53.9%), anxiety (70.8%) and stress (51.6 %) among the studied population. Screening of sickle cell anemia patients for depression, anxiety and stress symptoms is recommended at regular intervals

Exchange rate is an important macroeconomic variable that economic planners, policymakers as well as governments all over the world monitor very closely. This may be because volatility in exchange rate is capable of putting an entire nation in an acute state of disequilibrium. In Nigeria, economists and other stakeholders have continued to make relevant efforts to restore normalcy/stability to the nation’s exchange rate that has been subjected to severe rate of volatility in recent years. The Nigerian industrial sector remains a potentially viable alternative amidst the incessant widespread calls for diversification of the Nigerian economy. As such, it is not against conventional wisdom to say that since industrialisation may involve importation (of raw materials), exportation (of finished goods) or both; one may not be wrong to expect a link with exchange rate. Therefore, this study investigated the relationship between exchange rate volatility and industrial sector performance in Nigeria using quarterly time series data spanning from 1980Q1 to 2016Q4. The researchers relied on the use of OLS multiple regression technique for analysis while exchange rate volatility was generated using Exponential Generalised Autoregressive Conditional Heteroskedasticity (EGARCH). The result showed that exchange rate volatility is inversely related to industrial sector performance (using industrial sector contribution to GDP as a proxy) in Nigeria. Furthermore, trade openness was observed to have a negative sign (though statistically insignificant) while exchange rate and interest were also found to be strong and significant positive drivers of industrial sector performance in Nigeria. Following the findings, the Nigeria government and other stakeholders are advised to hasten efforts to arrest the perennial fluctuations in exchange rate in the country in order to stimulate expansion of productivity in industrial sector.

Glomerulonephritis (GN) is a common cause of end stage renal disease (ESRD). Electron microscopic studies bestowed significantly to the understanding of the pathogenesis of the disease process in GN. Its value has been strongly confirmed in diagnosis of glomerular diseases. To establish the role of electron microscopy in the diagnosis of glomerular diseases, in order to introduce services and to improve the histopathological standards of diagnosis of renal disease. Different patterns of EM in the different types of glomerular diseases in 132 renal biopsies from patients with glomerular diseases were evaluated. These specimens were stained and examined under the light microscopy (LM) then compared by transmission electron microscopy (TEM) findings. The most frequent types of glomerular disease was minimal change disease (22.7%), followed by lupus nephritis (20.5%). LM failed to diagnose the minimal change disease and Alport’s syndrome. In this study EM was found necessary in diagnosis of 37 cases (28%), supportive in diagnosis of 17 cases (12.9%) and not required in 79 (59.8%) of cases. The current study supported what had been concluded in the previous studies; EM still has an integral role and necessary for diagnosis of certain glomerularpathies e.g. minimal change disease.

According to the development trend of the transportation industry and rapid economic growth, China has carried out strategic layout and planning routes for the transportation industry. The National Development and Reform Commission have also issued a number of documents that promote the construction of a modern transportation system, and promote transportation projects such as railways, waterways, airports, and urban transportation. Besides, it continuously invests large amounts of money in companies in the transportation industry. The mission of companies in the transportation industry is of great importance. It can be seen that China’s transportation industry is at a stage of rapid development, and it has received strong support from the government. Nevertheless, it still has a long way to go. To improve the transportation infrastructure of the nation, companies in the transportation industry must strive to improve their corporate performance. This paper empirically investigates the impact of factors such as financial factors, internal operations, and corporate growth on the corporate performance of listed companies in the transportation industry, with the aim of helping listed companies in the transportation industry to develop a sound corporate strategy and conduct standardized and effective management to improve corporate performance. This paper selects data of 42 listed companies in the transportation industry from 2012 to 2016, and utilizes the fixed effect model that controls heteroskedasticity to analyze influencing factors of the corporate performance of listed companies in the transportation industry. Empirical results show that core ratio, return on personnel, long-term debt ratio, and quality of staff positively influences the corporate performance of listed companies in the transportation industry. Factors such as operation cost ratio, managerial cost ratio, size, and delay ratio have a negative impact on the corporate performance of listed companies in the transportation industry. Policy implications are proposed accordingly.

Abstract: The oxidative stress caused by free radicals and reactive oxygen species released during smoking can play a significant role in pathogenesis and development of Chronic Bronchitis. This study is conducted to evaluate serum levels of Malondialdehyde (MDA) a lipid peroxidation product as a marker of oxidative stress and vitamin C major antioxidant in body in chronic bronchitis patients and healthy controls. Comprised of 80 subjects, 40 healthy controls and 40 chronic bronchitis cases were included. Kei Satoh method used for measuring MDA and Serum vitamin C was estimated by method 2,4-Dintrophenyl hydrazine method Serum MDA a lipid peroxidation product from cell membrane considered as marker of oxidative stress was elevated in chronic bronchitis patients when compared to healthy controls where as serum level of vitamin C major antioxidant significantly decreased in chronic bronchitis patients when compared to controls.. MDA maker is of oxidative injury significantly increased in chronic bronchitis cases which is likely associated with active smoking habit and also be due to systemic inflammation. The decrease in level of antioxidant capacity in chronic bronchitis patients appears likely consequence of higher oxidative stress and increased consumption of antioxidants. By stopping smoking and advising antioxidant rich food may halt the further progression of chronic bronchitis disease.

Correct body positioning is a major nursing intervention to prevent respiratory problem and reduce complication. The important causes of neonatal deaths is birth asphyxia and along with serious infections results in more than 50% of all neonatal deaths.The study was conducted to assess the effect of positioning on physiological parameters of neonates admitted with respiratory problem and find out the difference among positions. The conceptual frame work of the study was based on Stuffle Beams evaluation model provides a framework for evaluation of an innovative intervention .The research design adopted was quasi experimental with one group post test design. The experiment was done by taking 60 neonates admitted for respiratory problem. The level of significance was found using “Z’’ test & ANOVA.The mean heart rate in prone position is 132.4  15.26 less than mean heart rate in lateral position is 137.8  9.82 and in supine position is 141.6  9.75. The mean oxygen saturation in prone position is 95.9  2.87 is higher than the mean oxygen saturation in lateral position is 88.9  2.49 and in supine position is 91.2  2.54. The mean respiration rate in prone position is 43.8  3.18 is less than in lateral position 51.4  4.33 and supine position is 52.2  1.9. The mean arterial pressure in supine position is 49.1  8.27 is same as in prone position is 49.1  8.12 and in lateral position is 48.56  7.57.The mean of oxygen saturation, respiration rate, heart rate in prone position is clinically effective. Prone position improves oxygen saturation and decrease respiratory distress in compared to supine and lateral position in neonates having respiratory problems.

The Private Hospital is a Charity Health Business owned by Private Business. The BPJS (the Social Security Organizing Body)procedure that must be carried out by the hospital is quite complicated and the lack of information for BPJS users, such as nurses inpatient rooms must always monitor the ceiling limit limit of BPJS rates and the difficulty of referring to other private hospitals. This study uses a descriptive quantitative approach. Data analysis of this study uses multiple linear regression analysis which is processed using the SPSS for Windows program. The sampling technique in this study used proportionate stratified random sampling and samples were 64 employees. The results of this study are reward, policy and and wages have a significant effect simultaneously on the employee performance in Private Hospital Surabaya. Second, the most dominant variable influencing employee performance in Private Hospital Surabaya is wages variable

The study measured the impact of exchange rate to financial remittance in Nigeria for the period 1990 to 2016 using the traditional ordinary least square method for estimation. Also, empirical and theoretical evidence from Nigeria. Africa and the continent was compared. The analyses of the OLS regression showed evidence that real effective exchange rate positively and significantly impacted on financial remittance in Nigeria. Similarly, estimates from the ordinary least square model provide evidence to show that exchange rate also positively significantly impacted on other macroeconomic variables such as money supply but negatively to economic growth under the period of the study. The result points to the fact that the macroeconomic variables and financial remittance in Nigeria if well managed can engineer the Nigerian economy to greater growth.

Abstract: Management of heart disease complicating pregnancy in a tertiary care centre is a great challenge to obstetricians and cardiologists. To know the maternal perinatal outcome of heart disease complicating pregnancies so that the quality of treatment in a tertiary care centre can be improved. Cardiac disease in pregnant women most commonly due to RHD, CHD, less commonly due to ischemic heart disease or cardiomyopathy. Though the frequency of RHD has decreased worldwide but still in developing countries like India, RHD is predominant. Admission of heart disease in pregnant women is approximately 30 of 2278 total deliveries from the month of june2018 to august2018 in MGMGH. The purpose of this study is to analyse all heart diseases in pregnancy and to characterize the clinical course, treatment and perinatal outcome in antenatal and postnatal women. Details of all antenatal or women less than 6 weeks postpartum admitted to MGMGH in the month of june to august 2018 were reviewed. Obstetric data included gestational age at the time of delivery, type, indication , location of delivery, congenital , rheumatic heart disease, operated , newly diagnosed were categorised depending on the major system involved. Out of 2278 deliveries from june2018 to august2018 in MGMGH, Trichy, 30 were heart disease complicating pregnancy. Rheumatic heart disease and congenital heart disease were more common. Operated congenital heart disease was also more common. Postnatally most of them required ICU monitoring and management. Incidence of Postpartum cardiomyopathy was very less in this study. Early anticipation of complications and close monitoring in the antenatal and perinatal period decreased maternal morbidity and mortality.