The realization of the principle of justice in proving the settlement of consumer disputes through arbitration in Indonesia is important, with three reasons, namely first, there is a weakness of the consumer protection law because the formulation of substantial norms and formal law is contrary to other laws so that the formulation is not in the framework national legal system and difficult to be harmonized. Second, the legal norms for consumer dispute settlement with an inverse proof burden system have created injustice for consumers and producers and open up opportunities for other parties to manipulate adverse evidence. Third, no matter how well the consumer dispute resolution process, does not guarantee that justice is achieved unless the judge (arbitrator) is right and correctly divides the burden of proof and provides an assessment of the strength of the evidence submitted by the disputing party. Discussion of the problem of proof, using the normative legal research method that refers to norms and legal principles in the legislation or court decisions. This discussion is explorative on thought, concrete legal norms in the Indonesian consumer protection law and is prescriptive to offer the concept of problem solving of the problems presented. The conclusion of the discussion is that the consumer arbitration verification system in Indonesia is a model that comes from the presumption of liability principle with a reverse proof burden. The realization of justice in this system cannot be harmonized so that it needs to be adjusted to the principle of justice that is universally adhered to and the principle of justice characterized by the legal personality of the Indonesian nation, namely Pancasila justice.

Many patients with gastrointestinal (GI) symptoms go through endoscopy often unnecessarily and without indication. Observational studies have generally shown poor adherence to international guidelines of endoscopy. This study aims to identify the common indications of GI endoscopy and the subsequent findings among the population of Al Kharj Province, KSA. We conducted a cross-sectional study on 516 patients who underwent upper or lower GI endoscopy at the Endoscopy Unit of King Khaled Hospital, Al Kharj, KSA in the period from March 2017 to March 2018. GI bleeding, dyspepsia and reflux symptoms were the most commonly reported causes for referral to endoscopy (26.8%, 19.6% and 10.7% respectively). Normal endoscopic findings were reported in 33% and 37% of the patients who underwent gastroscopy with dyspepsia and reflux symptoms, respectively). Only six patients (1.8%) of those who underwent colonoscopy had an indication of colorectal screening. Almost half of the patients 45 % (45/100) with dyspepsia 53% (27/55) unnecessary gastroscopy. High rates of unnecessary upper GI endoscopy are performed for inappropriate indication such as dyspepsia and reflux symptoms. Also, colorectal screening strategy has not been adopted by the physicians. We recommend the implementation of the recent international guidelines when referring patients to endoscopy to avoid the unnecessary invasive procedures.

Based on Lillian’s (2008) and Chen’s (2016) studies on women’s courtesy titles, this study makes a comparison and contrast of women’s courtesy titles in mainland China and Taiwan, with reference to those in the Whites and Blacks. It is based on a survey of a questionnaire, which is almost the same as the one used in Chen (2016) that was modelled on the one used in Lillian (2008). The results confirmed that age is an influential factor in the selection of courtesy titles for women of different marital status. It also confirmed Lillian’s observation that a woman’s occupational status may outweigh her marital status. However, even mainland China and Taiwan belong to the same Chinese community, they have statistically significant difference in women’s courtesy titles, especially in the use of XJ (Miss). Its fill-in-the-blank method of collecting women’s courtesy titles, rather than fixed-choices method, also seems to be effective.

Hyperuricemia is commonly seen in subjects with cardiovascular disease and it one of the risk factor for morbidity and mortality with cardiovascular diseases. Uric acid is a product of synthesis from nucleic acids, amino acids, and Kreb's Cycle. Uric acid is biologically active and can stimulate oxidative stress and endothelial dysfunctions, inflammation, and vasoconstriction. The present study tries to evaluate the levels of uric acid in patients suffering from an acute ischemic stroke in comparison with normal subjects. Methods: This prospective cross-sectional study was conducted in the Departments of General Medicine and Biochemistry Prathima Institute of Medical Sciences, Naganoor, Karimnagar. A total of 80 subjects were included in the study. They were divided into two groups. Group I [cases] (n=40) consisted of patients reporting to the Emergency Department within 24 hours of onset of symptoms of stroke. The Group II [controls] (n=40) were the age and sex-matched patients attending the General Medicine OPD with minor complaints. Results: The mean age of Group I (n=40) was 61.42 ± 2.99 years and Group II was (n=40) 48.9 ± 4.53 years. The numbers of the male in Group I were 29 and female were 11 and in control, Group was 20 male and female each. The blood urea Group I was 38.7 ± 5.59 mg/dl and in Group II 30.12 ± 8.86 the p values were not found to be significant. The serum creatinine was 1.13 ± 6.61 in group I and in Group II was 0.91± 0.17 mg/dl and the p values were found to be significant. The uric acid levels were 7.32 ± 2.25 mg/dl in group II and 4.95 ± 1.5 mg/dl in Group I the values were found to be significant. Conclusion: Within the limitations of the present study it can be concluded that serum uric acid levels are significantly associated with ischemic stroke in this group of the population. The other important factors for the risk of ischemic strokes include Hypertension and Diabetes mellitus. There is growing evidence that uric acid may play a key role in the development and progression of cardiovascular diseases

Present studies at home and abroad on V.S. Naipaul‟s novel In a Free State is not enough in the aspect of textual analysis. The in-depth studies in this aspect are wanted. This thesis aims to analyze the image existing in the title novella of In A Free State, one of the five novellas in the collection of In a Free state. By discussing the symbolic meaning of the three images and then comparing the symbolic meanings of these images, it can be inferred that Naipaul tends to criticize the mimic of the western civilization but praises the traditional African civilization.

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.

This paper investigates the mechanical properties of an aluminium oxide reinforced Eposand composites. The matrix a brand of epoxy was obtained from Shell Petroleum Development Company (SPDC) and reinforced with particulates of alumina in micro-scale. The resin and hardener were mixed and compounded in the ratio of 2:1 and through the application of centrifugal force was thoroughly compounded with the fillers. Two main mechanical tests of tensile and compression where carried out to obtain tensile, compressive, and yield strength of the composites. Four samples of 10%, 20%, 30%, and 40% by weight of alumina with five replications each were prepared and subjected the tests in accordance with ASTM D3039 and ASTM D3401M for tensile and compressive tests respectively. Maximum compressive strength of 133.3 MPa was recorded for 30% of filler, while maximum tensile strength of 7.9 MPa was obtained 10% of filler. An optimal yield strength of 3.4 MPa was recorded at 20% weight of filler. The analysis showed that the compressive strength increases with increase in percentage weight of alumina.

Metacognitive awareness can improve students‟ writing proficiency. Engaging and supporting students in the writing process can increase their metacognitive awareness. One of the major factors that impede the smooth acquisition of writing intelligibility by EFL learners is the transfer of L1 linguistic elements into L2, motivation is another alarming factor that affects Arab EFL learners‟ performance and anxiety is another predicament to students‟ performance in writing. The aim of the study is to verify the relationship between metacognitive strategies and other external factors L1 transfer, motivation, and anxiety. The researcher used descriptive statistic methods and the correlation coefficient between Metacognitive Strategies and others factor. Questionnaire technique is used as a method of data collection; the study group was formed from secondary school students Al-Mazar, Irbid. Data were generated through distributing the questionnaire from twenty-two students selected purposively from Irbid secondary school, Jordan. Only students from experimental group were eligible for answering the questionnaire. The data were analyzed by using SPSS program. The results showed that there is a positive and significant correlation between metacognitive strategies and motivation, L1 transfer and anxiety. Metacognitive strategies played an important role to enhance the writing performance among students, whereas the majority reported that they enjoy the writing actives during the class by using metacognitive strategies.

This study seeks to examine the relationship between Foreign Direct Investment (FDI) and Real Effective Exchange Rate (REER) volatility in Nigeria. Using annual time series data from 1980 to 2016, the study adopted the Exponential GARCH model, Ordinary Least Squares (OLS) estimation technique and the Error Correction Mechanism. The major findings of the study reveal that there is a negative correlation between Nigeria’s past and future REER, which further implies that negative shock has less effects on exchange rate volatility when compared with a positive shock. It also found that exchange rate has a very significant effect on FDI in Nigeria while there also exists a long-run relationship between them. The study therefore advocates for a strong foreign exchange policies by the CBN to attract FDI. It also suggests that CBN should be keen on monitoring the financial news in the economy as it could heighten exchange rate and financial market volatilities; which may not be good for the economy’s overall growth and development in the long-run.

Naso-Orbito-Ethmoidal fractures can occur in single entity or in conjunction with other craniofacial fractures. Most often they are associated with frontal Le Fort II or Le Fort III fractures. It involves nasal bones including bony septum, the frontal process of the maxilla and nasal–orbital–ethmoid complex bilaterally. Open and Closed reduction are the two ways of management which are adapted by surgeons according to the situation and severity. This article describes a case report of 21-year male patient with history of road traffic accident who is diagnosed with naso-orbito-ethmoid fracture and was treated with open reduction and internal fixation

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.

Primary immune thrombocytopenia (IT) is one of the common causes of thrombocytopenia in otherwise asymptomatic adults. Though most of the patients with IT are asymptomatic the presentation can be varied from mild petechiae to severe hemorrhage such as intracranial haemorrhage. Subconjunctival haemorrhage is an extremely rare presentation of IT. We report a 15 year old previously healthy boy presented with bilateral subconjunctival haemorrhage which was ultimately diagnosed as immune thrombocytopenia which was resistant to Steroid as well as IV Immunoglobulin therapy and managed with Rituximab successfully.

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.

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.

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.