The main purpose of this study is to explore the mediating role of occupational health & safety standard relationship between organizational innovation and business performance. Secondly, in order to get achieve this core objective of predictor direct and indirect relationship estimate on business performance. Methodology in this study was constructed mainly on the basis of quantitative method, where quantitative research estimated of essential to recover the knowledge base and measurement of vital aspects regarding the characteristics of management tools into test the hypotheses. This study has conducted been by stratified random sampling in which data were collected from Bangladesh ready-made garment factories. Data has been collected by survey questionnaire instrument. The data used that obtained from primary sources of survey questionnaire method. There are three hypotheses have been developed through literature review that tested using through correlation and liner regression analysis executed by SPSS 20.v software. Findings-while execution of survey data the mediating impact of occupational health & safety standard, it was found that statistically significant and positive impacts on the relationship between organizational innovation and business performance improved. Both predictors are highly correlation of each other with business performance to the significant and positive relationships. Recommendations- Further studies including with other standards can combine together to test and verifying the structural equation model concerning of measurement model and structural model fits.

Transfusion of Fresh frozen plasma is relatively common in neonatal intensive care units. Most common indications for transfusion being neonatal sepsis, deranged coagulation profile or co existence of both these conditions. However a universal protocol for FFP transfusion in neonates is lacking, leading to injudicious administration of FFP to neonates in many hospitals and thus exposing them to untoward risks of transfusion. This is our attempt towards analyzing the use of FFP in our neonatal intensive care unit and our compliance with the established guidelines (AIIMS protocol for FFP transfusion in neonates). Data was collected retrospectively of all the neonates who received FFP transfusions in our hospital from January 2014 to December 2017 and relevant analysis was performed. Most of the neonatal transfusions (93%) at our hospital during the study period were compliant with AIIMS guidelines. Most common indication for transfusion was bleeding manifestations followed by sepsis and deranged coagulation profile. However on analysis of pre and post transfusion coagulation parameters in these babies, no statistically significant improvement was seen. FFP was often used in accordance with the published guidelines in our study. However evidence based uniform guidelines need to be established and implemented to increase the benefit and minimise the risk associated with transfusion, especially in newborns.

Ankle fractures are the most common type of fractures treated by orthopedic surgeons in daily practice. Most of these fractures are complex type and difficult to manage. If not treated properly, may produce significant long-term disability and complications like pain, instability and early degenerative arthritis. Good functional results are obtained by surgical management of bimalleolar ankle fractures. Early weight bearing, and mobilization is achieved in these patients. This study was conducted at Prathima Institute of Medical Sciences, Karimnagar from January 2016 to December 2017. 40 adult patients with bimalleolar fractures of ankle who underwent open reduction and internal fixation were included in this study. Follow up was done at regular intervals of 6 weeks for minimum of 6 months. Baird and Jackson’s ankle scoring system of subjective, objective and radiographic criteria was used for the study. 24(60%) cases of medial malleolar fractures were fixed with malleolar screws, followed by cancellous screw in 4(10%) cases, tension band wiring in 10(25%) cases and K-wire in 2(5%) cases. 28(70%) cases of lateral malleolus were fixed with plate (24 with one-third tubular plate, 2 with 3.5mm DCP and 2 with 3.5mm recon plate) followed by malleolar screw in 4(10%) cases, Rush nail in 5(12.5%) cases and K wire/TBW in 3(7.5%) cases. Average time to union in our study was 10.4 weeks. However, most (80%) of the cases (80%) united by 8-12 weeks. Excellent results were achieved in 23(57.5%) cases, good results in 10(25%) cases, fair in 5(12.5%) cases and poor in 2(5%) cases. Open reduction and stable internal fixation of unstable bimalleolar ankle fractures restore the articular congruity of the ankle joint. Operative results in our study were satisfactory in 82.5% cases, with good to excellent functional outcome. Functional results were much better in younger age groups and men. Early weight bearing, and mobilization is achieved in these patients

Prostate gland of male reproductive system is about the size of walnut and surrounds the urethra. With increasing life expectancy, increasing awareness and better health services, lesions of prostate has become a common specimen received for diagnostic of both benign and malignant lesions which may have a very similar presentation but their management and prognosis is quite different. Most important investigation is the biopsy of the prostate. A histopathological study of features of the lesion gives best diagnosis. Our objective of study is to evaluate the spectrum and correlation of prostatic lesions with presenting complaints of the patient. It was a combined cross-sectional study conducted in Pathology Departments of both Bhaskar Medical College and Satya Diagnostic Centre, Himayath Nagar during the period from November 2015 to October 2017.

University academic society should be made aware that implementation of good governance does not only pose an obligation, but rather a necessity. Along with the increasingly fierce competitive situation, a University must consistently apply good university governance as a system attached to the university dynamics. Implementation of good governance values at universities can be integrated into a higher education culture. This research for the first year aims to identify the concept of the implementation of good governance at private universities in the city of Medan. This research is expected to increase efficiency, transparency, and consistency within private universities in Medan. In order to measure the implementation of the concept of Good Governance at the Private Universities in The city of Medan, the parameters of the aspects of transparency, participation, legal sovereignty or compliance with regulations, accountability, and effectiveness were used. The results of this study revealed that Good Governance has been implemented in Private University in The city of Medan and the aspects of transparency, participation, law supremacy or regulatory compliance, accountability, and effectiveness have well been implemented.

Endoscopy with endoscopic biopsy is currently the major method of diagnosis of gastrointestinal (GI) neoplasms. A total of 60 endoscopic biopsy specimens from upper and lower gastrointestinal tract were studied in the laboratory from November 2013 to October 2014 in the department of pathology, Acharya Shree Chander College of Medical Sciences and Hospital (ASCOMS), Jammu. Of these gastrointestinal biopsies 25 (41.66%) were from upper gastrointestinal tract and 35 (58.33%) were from the lower gastrointestinal tract. Among these upper and lower GI biopsies a total of 35 (58.33%) suspected neoplastic lesions were included in the present study. The biopsies that were included in the study comprised of 6 (10%) esophageal biopsies, 12 (20 %) gastric biopsies, 3 (5%) from GEJ, 4 (6.66%) from duodenum, 2(3.33%) from pyloro-duodenum, 1 (1.66%) from jejunum, 2 (3.33%) from ileum, 14 (23.24%) from colon, 12 (20%) from rectum, 4 (15%) from anus. There are only few studies on histopathological spectrum on GI endoscopic biopsies in Jammu region. ASCOMS is a tertiary care hospital where patients come from all over Jammu region. Analysis of biopsied material therefore can provide a fairly good estimate of spectrum of various gastrointestinal lesions (neoplastic/non-neoplastic/pre-neoplastic) in Jammu region as well as comparison of our results with similar studies in other institutions.

Systemic lupus erythematosus (SLE) is a prototypic systemic autoimmune disease with variable multisystem involvement and heterogeneous clinical features. Haematological abnormalities were common findings in patients with SLE. Sometimes, haematological abnormalities can be caused by the pathophysiology of SLE itself, but at other times the anaemia may not be directly related to the SLE. This retrospective study included patients who were diagnosed according to the American college of rheumatology criteria and treated for SLE from April 2015 to March 2018 at Olabisi Onabanjo University Teaching Hospital (OOUTH), Sagamu, Ogun State, Nigeria. The Demographic and haematological parameters at diagnosis were recorded. A total of 26 SLE patients were seen. All the cases were females and the mean age was 33.3± 8.9 years. Twenty-two (84.6%) had haematological abnormalities. Anaemia was present in 20 (76.9%) patients with a mean hemoglobin value of 8.6 mg/dl at the time of first presentation. Leukopenia was seen in 6 (23.1%), lymphopenia in 17 (65.4%), thrombocytopenia in 8 (30.8%) and 2 (7.7%) patients presented with anti-phospholipid antibody syndrome. The most common hematological abnormality among our patients was anemia which has a multifactorial aetiology. Lymphopenia was far more common than leucopenia.

Visceral Leishmaniasis is a vector-borne parasitic infection caused by a parasite of the genus Leishmania. This disease, which is more frequent between children than adults, knew during these last few years in Morocco a significant surge especially in the region of Fez. The direct examination, based on the detection of the parasite or its nucleic acid, is undoubtedly the key to a definite diagnosis, along with serological techniques that were proven to be efficient and could also aid the diagnosis. This study highlights the benefit of rK39 rapid tests in visceral Leishmaniasis diagnosis through the retrospective of 75 patients suspected to have Visceral Leishmaniasis. We shall also compare our results with those of other authors in different countries.

Thyroid Dysfunction (TD) and Diabetes Mellitus (DM) are often found associated in the same patient and TD may affect the metabolic control of DM. TD is more prevalent in diabetics than in general population. The current study investigates the prevalence of TD in patients with DM, and explores its correlation with age, sex, type and duration of DM, and glycemic control (HbA1c levels). This was an observational, cross-sectional study of 212 patients with DM. All patients had undergone routine clinical and laboratory evaluations as per the standard clinical care. Medical data was collected and analyzed using Epi Info V3.5.4. Among the 212 DM patients evaluated, the overall prevalence of TD was 24.52%. The overall prevalence of TD was less in type-2 DM (T2DM; 24.46%) as compared to type-1 DM (T1DM; 37.5%); and slightly more in females (31.94%) as compared to males (28.65%). The prevalence of TD was high in the middle age (41-60 years) group (52.17%) as compared to other age groups. Subclinical hypothyroidism (SCH) was the most common type of TD (11.79%) with maximum prevalence (50%) in T2DM. Patients with DM reported a high prevalence rate of 24.52% for TD. Patients between 41-60 years of age had higher prevalence of TD. Prevalence was slightly more in more in females as compared to males. Our data suggests for screening of DM patients for risk of TD that might be helpful in secondary and primary prevention and possible better metabolic control

Pseudomonas aeruginosa is a true opportunistic pathogen and is responsible for causing a variety of infections in clinical settings in both immunocompetent as well as immunocompromised hosts. However, in most cases, P.aeruginosa infections occur in patients who have been compromised in some way, e.g. chronic Diabetic Patients. Methods: In this study a total of 280 (10.98%) P.aeruginosa isolates were obtained out of 2549 samples collected for a period of 5 years. The isolates were selected on the basis of their growth characteristics on Blood agar, MacConkey agar and Nutrient agar medium. Colonies were subjected to series of biochemical tests to identify the species. Antimicrobial susceptibility testing of all the confirmed P.aeruginosa isolates was performed by automated walkaway 96 using NBC 42 and conventionally comparing with Kirby–Bauer disc diffusion method for further confirmation and results were interpreted according to CLSIs guidelines. Results: The prevalence of this pathogen was 10.98% and most of the isolates were mostly isolated from pus/wound swab cultures, followed by urine & sputum cultures, mostly isolated from critical areas such as ICU’s.

Chronic Obstructive Pulmonary Disease is associated with increased inflammatory cells. Combination of long acting beta agonist and inhaled corticosteroids are standard treatment. Roflumilast targets inflammatory cells and decreases the frequency of exacerbation. This study looks at the effect of Roflumilast on inflammatory cells in sputum and inflammatory markers in the blood when used as add-on therapy in COPD patients. This observational comparative study conducted in Department of Pulmonary Medicine for 1.5 years duration. 70 COPD patients were divided into two Group A (Roflumilast + Standard treatment) and Group B (Standard treatment). Pulmonary Function Test, Sputum Eosinophil & Sputum Neutrophil, CRP were measured at baseline and after 4 months of treatment in both groups. Intergroup analysis between Group A and Group B was done at baseline and after 4 months. Mean age of patients in Group A was 64.3 years and in Group B was 61.2 years. Maximum patients were in age groups 51-60 and 61-70 years. Of total 70 patients, 60% were males and 40% females. Majority of patients in both groups had low BMI. Sputum inflammatory cells were significantly lower in Roflumilast group. Pulmonary function parameters showed significant improvement in Roflumilast treated group. There was no significant decrease in CRP when compared between two groups. Roflumilast, add-on therapy to standard treatment in COPD patients have improved lung function and decreased level of inflammatory cells in airway significantly.

Tuberculosis, inspite of advances in diagnosis and therapeutics still continues to be the leading cause of mortality and morbidity in many developing countries even today. It is one of the major killer infectious disease. In recent years, two important factors which heavily complicate the treatment outcome of tuberculosis patients are MDR-TB and XDR-TB.The mortality in Tuberculosis mainly due to delay in diagnosis. India has the highest TB burden accounting for 1/5 th of Global incidence. The most common form of TB is pulmonary tuberculosis. The sputum microscopy and culture both of them are backbone for the diagnosis of Tuberculosis. The present study aimed to compare and evaluate the of Trisodium Phosphate solution as sputum concentration technique by smear microscopy (Zeihl Neelsen Technique), to compare the smear microscopy. Sputum samples of suspected 150 cases of pulmonary tuberculosis attending Thoracic Medicine and General Medicine OPD at Thanjavur Medical College, (Tamil Nadu) were collected and processed for smear microcopy. Among the 150 sputum samples, AFB positivity in unconcentrated sputum microscopy by Zeihl Neelsen Technique-33(22%),AFB positivity in concentrated sputum microscopy by Zeihl Neelsen Technique-37(25%).The present study confirms that the importance of Trisodium Phosphate solution for sputum concentration technique for the smear microscopy by Zeihl Neelsen Technique.

The present study aimed to investigate role of Attitudes towards medication, subjective norms and Perceived Behavioral Control in predicting Intentions of patients to take Anti-TB medication. The sample comprised of 147 patients with pulmonary TB, recruited from Gulab Devi Chest Hospital, Lahore. Correlation Research design was used. Urdu translated version of Theory of planned behavior questionnaire was used for assessment. Results showed that, Distance to hospital and Attitude of doctors and staff negatively predicted Intentions. However, Monthly family Income, Attitudes towards medication and Subjective Norms positively predicted Intentions. Results also revealed that high and low intenders were significantly different in terms of Behavioral, Normative and Control Beliefs. Findings of the present study highlighted the importance of environmental and patient related factors influencing the decisions to take medication. These factors should be considered while developing interventions to promote future medication adherence behavior as intentions drives behavior and patients has to be motivated in order to perform the behavior.

Mesenchymal hamartoma of liver is the second most common benign liver tumor in children after hepatoblastoma. First described in 2006 as multicystic biliary hamartoma, it generally presents as large multicystic mass in less than three years of age.We report one such case in a 3 year old male child who came with history of fever and rash and was incidentally diagnosed with a cystic mass in the liver. Partial hepatectomy was done which on microscopy revealed epithelial structures in loose connective tissue stroma along with cystically dilated spaces lined by columnar and flattened epithelial cells, typical of Mesenchymal Hamartoma of liver. We are presenting this case because of its rarity.

Strong writers actively and metacognitively involve themselves in the writing process by spending more time recursively planning and refining their writing by actively monitoring and adjusting the text they are generating and by maintaining an awareness of their audience. Research shows that training in Meta-cognition Strategies that are used to Improve Writing Disabilities and performances have been successful. The purpose of the present study was to study Comparison of Using Metacognitive Strategies on Writing Performance in Private and Government Schools in Jordan. We have investigated the effect of Meta-cognitive strategy training through the use of explicit and teaching intervention strategy instruction on Improve Writing Disabilities among 12th Standard students. To reach the goal of the study two groups of Writing Disabilities in 12th Standard students were randomly assigned to a control and an experimental group. The experimental groups received instruction on Meta-cognitive strategy training through a 12- week period of instruction while the control groups received traditional way. The result of the study showed that explicit Meta-cognitive strategy training has a significant positive effect on Improve Writing performance and Disabilities in 12th Standard students. The collected data were analyzed by using SPSS software version 23.