The study was conducted to determine the Etiological basis of dizziness in patients attending ENT clinics in Pakistan. It was a prospective, multicenter, observational, non-interventional, cross - sectional study conducted in five cities across Pakistan, between August, 2014 and March, 2015. The study population included male and female patients attending the outpatient clinics of ENT departments. The patient population was of 18 years of age or older presenting with dizziness. Based on the initial screening patients were diagnosed as vertiginous or non-vertiginous. Patients’ written authorization to use or disclose the patient’s personal or health data was obtained. Benign Paroxysmal Positional Vertigo was the commonest diagnosis (67%) followed by Meniere’s disease (16%) in patients who presented with vertigo attending outpatient departments in ENT Clinics. At baseline visit, 38.3% of the patients were categorized as moderately handicapped. Medication was offered to three quarter of the patient population (69%), while rest of the patients were offered maneuver and medication both (20.8%) and only maneuver (3.5%). DHI was used at the baseline visit and post treatment as well. It was observed in the study that the DHI score was significantly improved in all diagnosis groups after the treatment. At the end of four weeks majority of the patients were categorized mildly handicapped (91.3%). Majority of the patients diagnosed as BPPV were prescribed anti-vertiginous medicines (70%) followed by anti-emetics and pain killers. Amongst the patient reporting with dizziness the commonest diagnosis was Benign Positional Paroxysmal Vertigo followed by Meniere’s disease. Based on pre and post-treatment DHI scores, medication and medication with maneuver helped the patients presenting with dizziness in improvement of Quality of Life.

Excess free-radical formation has been hypothesized to contribute to cancer, atherosclerosis, aging, and exercise-associated muscle damage. Antioxidant supplements such as vitamin C, vitamin E, and beta-carotene have been touted as beneficial for enhancing exercise performance and for preventing certain diseases. Before physicians routinely recommend supplements to prevent exercise-associated damage, more study will be required. Recommendations for the prevention of cardiovascular disease and cancer are more complex. Because study results have been contradictory, individual supplement recommendations must be offered with caution. Physicians must be cognizant of which supplements patients are taking and be prepared to discuss risks and benefits. The most beneficial prescription is probably a daily diet containing five to seven servings of fruits and vegetables..Muscular exercise promotes the production of radicals and other reactive oxygen species in the working muscle. Growing evidence indicates that reactive oxygen species are responsible for exercise-induced protein oxidation and contribute to muscle fatigue. To protect against exercise-induced oxidative injury, muscle cells contain complex endogenous cellular defence mechanisms (enzymatic and non-enzymatic antioxidants) to eliminate reactive oxygen species. Furthermore, exogenous dietary antioxidants interact with endogenous antioxidants to form a cooperative network of cellular antioxidants. Knowledge that exercise-induced oxidant formation can contribute to muscle fatigue has resulted in numerous investigations examining the effects of antioxidant supplementation on human exercise performance. To date, there is limited evidence that dietary supplementation with antioxidants will improve human performance. Furthermore, it is currently unclear whether regular vigorous exercise increases the need for dietary intake of antioxidants. Clearly, additional research that analyses the antioxidant requirements of individual athletes is needed

Since the 21st century, the science and technology have developed by leaps and bounds. At the same time, with the increasing exchanges among countries in politics, culture, science and technology, trade and so on, cross-cultural communication has attracted more and more attention. It is worth noting that in the process of cross-cultural communication, due to the different cultures, mistakes, contradictions and conflicts are emerging. Different countries, different peoples have their own unique culture, so misunderstandings always happen. The different cultures, values and ways of thinking, often lead to the failure of communication, which seriously affects the efficiency of cross-cultural communication. Therefore, through the analysis of pragmatic failure in cross-cultural communication, this paper tries to find a solution to this problem.

DSM V has removed OCD from Anxiety disorder group and classified the disorders with similar clinical picture together under obsessive compulsive and related disorders (OCRD). The following disorders fall under this group. Obsessive compulsive disorder, Body dysmorphic disorder, Hoarding disorder, Trichotillomania, excoriation disorder, substance/ medication induced obsessive compulsive and related disorders. This study aims to assess sociodemographic factors, sex-specific occurrence of OCRD and psychiatric and neurodevelopmental comorbidities of OCRD in children attending a child guidance clinic of R.G Kar Medical college, Kolkata. The study has been done based on the register used to record the patient related data in the child guidance clinic. All cases aged up to 12 years of age, of both sexes, registered with any diagnosis under obsessive compulsive and related disorders from July, 2009 to June 2015 (6 years) were included in the study. Results and statistical analysis were done using SPSS 23. Total 684 cases attended the clinic. Of them number of children diagnosed with obsessive compulsive and related disorders was 48 (7.02%). Most patients were in the age group 8 – 12 years. In all age groups males were more in number than females. Among males most common disorder among Obsessive compulsive and related disorder was Tic Disorder (TD) and among female most common disorder was OCD (44.4%) and next was OCD with Tic disorder (33.3%). Most common comorbidity was Attention deficit hyperactivity disorder

Project Management in Guinea is growing rapidly such as in many developing countries. It’s heavily used now in diverse area such as in agriculture, construction, manufacturing, telecoms, IT, education, and so on. This high prevalence of making projects in various sectors determined the increasing importance of effective project management. Managing project rightly at a right time with multiple constraints (human and technical aspect) remains the main challenge for project managers. The relationship concerning successful project and the project success factors are topics of great interest in project management. The paper highlights the most Critical Success Factors (CSFs) through project planning, project top management support and stakeholder involvement in project implementation in Guinea.

Diabetes mellitus (DM) is commonly referred to as a “sugar” and it is the most common endocrine disorder and usually occurs when there is deficiency or absence of insulin or rarely, impairment of insulin activity (insulin resistance). The powdered leaves phoenix dactylifera was extracted with 400ml of 70 % v/v of ethanol and water for 5 hour in soxhelet. Alloxan monohydrate at a dose of 150 mg/kg injected intraperitonally for induction of diabetes mellitus. The extract of Phoenix dactylifera leaves was subjected to anti-diabetic activity in rats. Group-IV & Group-V received the ethanolic & aqueous extract of phoenix dactylifera leaves(500mg/kg) shown a marked reduction in blood glucose level on day 4th i.e. in ethanolic extract it was 284.76±mg/dl while in aqueous extract it was 264.76±6.65. On 10th day of study the glucose level falls up to 264.40±7.72 in ethanolic extract rat & 254.05±9.18 in aqueous extract. The results of the present study indicate that Phoenix dactylifera leaf extract was found to reduce the glucose level in animals made diabetic with alloxan. In the present investigation ethanolic extract of Phoenix dactylifera leaf showed significant anti-diabetic activity

Intravenous induction agents Propofol and Thiopentone are commonly used in obstetric anesthesia. We in the present study tried to compare the effects of Propofol and thiopentone on hemodynamics, Heart rate in the pregnant ladies undergoing Cesarean sections. Methods A total of 60 patients were included in the study. They were randomly divided into two groups. Propofol group (n=30) and Thiopentone group (n=30). The dosage was calculated to body weight 5mg/Kg for thiopentone and 2.5mg/Kg for Propofol. The mean induction time in Propofol group was 20.95 seconds and Thiopentone group as 26.5 seconds. There was smooth induction in 86.67% of the patients of Propofol group and 13.33% had disturbed induction. In the Thiopentone group, 76.67% had smooth induction and 23.33% had disturbed induction. No induction failure was encountered in this study and all patients were unconscious after 45 seconds. The total duration of surgery in propofol group was 70 ± 20 minutes and in thiopentone group was 85 ± 27. The time to extubation in Propofol group was 8.5 ± 2.60 and Thiopentone group was 7.0 ± 3.56. The Arterial Blood gas analysis after surgery shows average values of PaO2 in Propofol group and 87.5 ± 2.1 and thiopentone group 88.6 ± 1.8 and PaCO2 in propofol group 38.6 ± 2.05 and thiopentone 38.4 ± 2.5 mmHg. The mean SBP at the baseline of Propofol group was 124.05 ± 10.5 mmHg, while for Thiopentone group it was 124.05 ± 10.5 mmHg. The mean DBP at the baseline in propofol group was 76.5 ± 10.2 and thiopentone group was 78.8 ± 6.8. The heart rates were 80.5 ± 7.8 beats/min and 83.5 ± 8.8 beats/min in propofol and thiopentone group. The mean changes at the time of induction in heart rate of propofol group were 18 beats/min and the mean change of heart in thiopentone group was 23 beats/min. The mean SBP change during induction in Propofol group was -2.8mmHg and DBP change was -2.0 mmHg. In thiopentone group SBP change was -2.55mmHg and DBP change was -1.3 mmHg. Conclusion: Propofol has rapid actions and does not have any adverse effects on the CVS. The amount of pain produced due to propofol was also lesser compared to the thiopentone group and the induction was smooth in propofol group compared to thiopentone group and overall outcomes of Propofol were better than the Thiopentone group. Therefore propofol appears to better induction agent than thiopentone for obstetric anesthesia

Staphylococcus aureus is a common bacterium that affects humans and causes several syndromes and infections with fast evolution which can endanger the patient's life. Investigate the incidence of nasal carriers of S. aureus among graduation nursing students who attends to the hospital for at least one year. 122 samples from the nasal cavities were analyzed. The identification of the bacteria was performed by conventional bacteriological methods. The antimicrobial susceptibility tests were performed using the BioMerieux Vitek system in the Bacteriology Laboratory of the Brazilian Army Biology Institute - IBEx. Of the 122 examined students, 51 were carriers of S. aureus, corresponding to a prevalence of 41.8%. The results demonstrated that nursing students who attend the hospital environment are more susceptible to carry S. aureus antibiotic-resistant strains. We suggest periodic medical exams to these students for appropriated antibiotic therapy and adopt precautionary measures in order to avoid the interpersonal transmission of the bacteria in the relationship with health professionals and patients at the hospital environment

This study investigates the importance of critical thinking skills for domain specificity. A theatrical research is carried out to highlight the use of critical thinking skills for domain specificity. Literature highlights that students use their critical thinking skills in a specific domain and perform better in classroom and at work place. Literature further highlights that teachers must facilitate students in the knowledge of critical thinking skills by using their own critical faculties. Likewise, advocates of critical thinking stress that institutes must produce critical thinkers. Literature focuses on domain specificity for the use of critical thinking skills. Studies show that in a specific domain learners critically comprehend, analyze, infer and evaluate text and finally become critical thinkers in a specific domain.

The aim of this study was to examine the effect of leadership style, organizational culture, and achievement motivation toward qari’ (man reciter of al-Qur’an) and qari'a (woman reciter of al-Qur’an) organizational commitment at LPTQ (The Institution for the Development of Tilawatil Qur'an) in Riau islands area. This research particularly was conducted separately on three parts of region namely; in the center, Province of Riau Islands (City of Batam); in the western region (Karimun Regency); and in the eastern region (Tanjung Pinang City). Survey method applied in this study along with path analysis used in hypothesis testing. The total of respondents amounted to 204, but only 186 in a number of respondents who returned the sheet of questionnaires. The total respondents for trials were as many as 30 participants. Each region was represented by 10 respondents, Alpha Cronbach formula used in these trials. The results revealed that there were a positive influence and significant: 1) Leadership style on qari' and qari's Organizational Commitment. 2) Organizational Culture on qari' and qari's Organizational Commitment. 3) Significant Leadership style on Achievement Motivation. 4) Leadership style, Organizational Culture on Achievement Motivation. 5) Leadership style, Organizational Culture and Achievement Motivation towards qari’ and qari'a Organizational Commitment in Riau Islands. The study concluded that: There were direct influences of leadership style, organizational culture and achievement motivation towards the organizational commitment of qari’ and qaria’. Based on the calculation of path analysis obtained Fobtained (24,69) > Ftable (2.67). So H0 was rejected and Hi was accepted. It meant that the style of leadership, organizational culture, and achievement motivation gave a significant influence on the commitment of the qari and qari’a organization.

The principle of the minimally invasive technique is to implant specific bony plate which is fixed across fractures via small incisions of the skin, muscle, and periosteum. The aim of the study was to find the functional outcomes in patients treated with proximal humerus fractures with a minimally invasive technique using locking compression plates. Methods: The cross-sectional study was conducted in the Department of Orthopedics, Prathima Institute of Medical Sciences, Nagunur, Karimnagar. A total of 39 patients were included in the study. The patients were selected using the inclusion criteria and they underwent operations under general anesthesia followed by early mobilization and follow up at the intervals of 3 months, 6 months and 12 months to evaluate functional outcomes according to Constant-Murley criteria. Results: The fractures were classified according to the NEER/AO/ASIF classification of fractures of the humerus. The type A fractures were found in 20 out of 39 patients 51.28% A1 fractures were in 8 patients A2 in 5 patients and A3 in 7 patients and 19 fractures were type B 48.72% and B1 and B3 had in 7 patients each and B2 had 5 patients. The mean Constant-Murley score was 89.25 points at the end of one year follow up in 2 part fractures. According to Constant-Murley score, 85% had an excellent outcome, 10% had a good functional outcome and 5% had moderate outcomes. All the fractures were united on an average time of 19 weeks (14-24). In the Three-part fractures, the average Constant-Murley score at the end of one year was 81 points. The Constant-Murley score showed 78.94% had excellent outcomes, 15% had a good functional outcome and 5.26% had a moderate outcome. Conclusion: Within the limitation of the present study it can be concluded that minimal invasive plate osteosynthesis with locking compression plate is a good technique for the treatment of proximal humerus fractures. It provides good stability, functional outcomes and minimal post-operative complications

India is a tropical country where skin diseases like fungal infections, pyoderma, acne, scabies etc. are very common. A large number of dermatological preparations are available in Indian market but studies on the price variation between commonly used topical brands are lacking. Hence the present study was carried out to obtain information on the price variation among different brands of anti-infective, anti-acne & analgesic topical preparations present in India. Information about dosage forms and prices of different brands of commonly used topical preparations was obtained from Current Index of Medical Specialties & Drug Update. Number of brands, percentage price variation, cost ratio etc for various drugs and combinations were calculated. There were total 206 brands manufactured by 52 different pharmaceutical companies of 35 drugs, out of which 24 showed more than 50% cost variation. Largest price variations were seen with mupirocin 2% cream (408.33 %), tazarotene 0.05% gel (183.8%) and diclofenac diethylammonium 1% gel (650 %) in single drug categories & gentamicin 0.1% + clobetasol 0.05% cream (308.82 %) among all fixed dose combinations. Least variation was observed for salicylic acid 2% foam (4.76 %) and terbinafine 1% + ofloxacin 0.75% + ornidazole 2% + clobetasol 0.05% cream (5.69 %). Cost of drugs play a crucial role in treatment outcome by directly influencing the patient compliance. Hence, it is essential to train physicians about cost variations among different brands available in the market so that they can reduce financial burden of patients without compromising the effectiveness of therapy.

Suxamethonium is the drug of choice for muscle relaxation for endotracheal intubation with its rapid onset and short duration of action. The newly introduced non-depolarizing drug rocuronium has got rapid onset and intermediate duration of action. The aim of the present study was to compare the intubating conditions of rocuronium bromide with suxamethonium chloride. Aim: To compare the onset and duration of action of Rocuronium Bromide and Suxamethonium Chloride. Methods: it is prospective randomized controlled study carried on 90 adult patients with age groups of 20-60 years of either sex. They were posted for elective surgery in MGM’s Hospital Aurangabad. They were randomly divided into two groups of (n=45) each. Group I (R) patients received rocuronium at the dose of 0.9mg/Kg and Group II(S) patients received suxamethonium at the doses of 1.5mg/Kg. Results: In Group I (R) group there were 14 (31%) male patients and female were 31 (69%). In group II (S) there were 14 (31%) male and female were 31 (69%). In group II (S) suxamethonium showed acceptable intubating conditions in 100% of cases at 60 sec out of which 93.24% were excellent. In rocuronium group I(R) 100% cases had acceptable intubating conditions at 60 seconds out of which 77.7% excellent and 22.3% had good intubating conditions the P values were significant. In both the groups there was no significant difference jaw relaxation as well as vocal cord movements. There was the significant difference in response to intubation in Rocuronium group 6 (13%) patients had a mild cough on intubation whereas no patient in suxamethonium group II had any cough. In the Group I 24% patients had slight diaphragmatic movements on intubation and in group II 11% had diaphragmatic movements. There was no significant rise in HR difference in group I and group II preoperative, post muscle relaxant, 0 minutes after intubation, 5 minutes after intubation, and 10 minutes after intubation. Conclusion: Rocuronium bromide at the dose of 0.9 mg/Kg produces excellent and good intubating conditions in patients although slightly inferior to that provided by the Suxamethonium 1.5mg/Kg but there is more hemodynamic stability with rocuronium then suxamethonium. Therefore Rocuronium bromide may be considered as safe and good alternative to suxamethonium for endotracheal intubation. Hence rocuronium bromide can be used for a rapid sequence of induction and intubation if there is no prediction of difficult intubation

Ocular diseases have been documented as the most common health problems universally. Most of the chemicals and synthetic drugs currently in use have marked side effects. Hence, there has been an ideal shift from the use of modern drugs to the age old herbs. Randia dumetorum Lamk is one such important plant with various established medicinal properties. The aim of the present study was to evaluate the preliminary antibacterial activity of methanolic extract of Randia dumetorum Lamk. (Xeromphis spinosa Thumb) Against common ocular pathogens such as Serratia marcescens, S. agalactiae, Corynebacterium macbinleys and Propionibacterium acnes. Methanolic extract of the dried fruits of the plant was prepared. Different concentrations of the dried fruit extracts (R. dumetorum) were transferred to the nutrient agar plates, which had been previously inoculated with the test microorganisms. The plates were incubated at 37°C for 24 h in an incubator and the zones of inhibition were measured using well diffusion method. The extract showed potential antibacterial properties comparable with that of the standard streptomycin against the organisms tested. The methanol extract of R. dumetorum displayed a concentration related antibacterial activity. The results showed that the inhibition of the bacterial growth was more pronounced on Corynebacterium macbinleys as compared to the other tested organisms

Psoriasis is a common chronic, recurrent, immune mediated disease of the skin and joints. It can have a significant negative impact on the physical, emotional and psychosocial wellbeing of affected patients. Many Ayurvedic texts have explained skin diseases, which resembles Psoriasis. According these references, Psoriasis can be considered as the vitiation of Vata and Kapha. The “wrong diet” is the major link for disease manifestation. Hence elimination of this „wrong diet‟ & implementation of corrective diet plays a major role in breaking the „Samprapti‟. The Dietary interventions for Psoriasis or any skin disease can have the following seven components- Nidana Parivarjana, Avashta anusara ahara sevana, Matra consideration, avoiding unwholesome diet, observing proper mental status during food intake, Prescription of specific disease related diet, and very important one- Education about Aahara. The article intends to uplift the importance of holistic approach towards diet prescription rather than only disease specific diet.