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.

The key issues of implementing internet marketing are revealed. Specified for one of the varieties of online marketing– conversion marketing. The general principles for determining the model of Internet marketing conversion are revealed. The basis of formalization of the general model of Internet marketing is offered. The main tasks of the solution of key tasks of the conversion Internet marketing are outlined.

Once prescribed, within a hospital structure, the drug will follow a complex circuit, involving many intermediates, human and technical, and leading to the drug administration and its monitoring. From the point of view of pharmaceutical practice, the circuit is of course made of an important logistic part but also of a clinical part often underestimated but nevertheless essential to the safety of the patients during their stay in the hospital. In order to be able to combine the logistic and clinical aspect of the pharmaceutical activity in a hospital environment, it is essential to adopt an appropriate dispensing mode that allows to better secure the patient's medication management. The purpose of this article is to describe the practice of the nominative dispensing in hospital and to share the experience of introduction of this practice at the pharmacy of the Moroccan Institute of Oncology

The Kenyan government is currently supporting the start-up as well as the growth of youth enterprises, in line with the Medium Term Plan of Vision 2030, by creating a conducive environment and support programmes in order to develop the sector. Despite these efforts, the performance of youth enterprises in Kenya has been miserable. The breadth to which this huge amount of money has influenced the growth and profit margins of these many youth enterprises remains unexplored. Furthermore, there is a lack of enough literature as far as the effect of youth enterprise development fund on the growth of MSEs. This research, therefore, sought to establish the effect of Youth Enterprise Development Fund services on the growth of MSEs in Nyando Constituency. The objectives that guided this study include: to determine the effect of YEDF lending financing services on growth of youth MSEs in Nyando Constituency; to determine the effect of YEDF linkage services with large enterprises on growth of youth MSEs in Nyando Constituency; to establish the effect of YEDF marketing services on growth of youth MSEs locally and internationally in Nyando Constituency and to determine the extent to which YEDF provides Business Development Services to Youth MSEs in Nyando Constituency. A descriptive survey research design was employed.

Acute intestinal obstruction is a common surgical emergency that a general surgeon comes across and one has to accomplish the skills of diagnosing art of Surgery and knowledge of postoperative management, which carries gratifying results. With this in mind, we in this study the tried to evaluate the symptomatology of Intestinal Obstruction to study the various causes of intestinal obstruction modalities of surgical procedures and its outcome. Methods: The cross-sectional study was conducted at the Department of General Surgery, Prathima Institute of Medical Sciences, Karimnagar. A total of hundred patients belonging to both sex groups were included in the study. All patients were evaluated thoroughly from their history and clinical examination. Patients with signs and symptoms of acute obstruction were managed by appropriate surgical procedure after resuscitation and the diagnosis was established. The postoperative period was monitored carefully and all parameters were recorded hourly or fourth hourly basis depending upon the resuscitation and the diagnosis was established. Results: The most common involved age group was 31 - 40 having 40% of the patients followed by 14 – 50 has 38%. Adhesions are the most common cause of intestinal obstruction accounting for 36% of the cases. Malignancy of the large bowel was found to cause obstructive features with a single case being due to ascending colon growth, one case of small bowel tumor and the 7 is due to recto-sigmoid growth, 2 descending colon, thus a total of 11 cases of malignant obstruction. 39 patients who underwent surgical procedure had no complications. 25 patients had wound infection with wound gaping and had to be treated with secondary suturing. 8 patients who underwent surgery expired with an overall mortality rate of 8 %. Conclusion: Clinical radiological and operative findings put together can bring about the best and accurate diagnosis of intestinal obstruction. Intestinal obstruction with tuberculosis of the intestine is more likely to develop postoperative complications, proper anti-tubercular management is necessary to prevent mortality and morbidity.

Research active status of Library and Information Science (LIS) in India has been studied using publications indexed in the Scopus database. ―Library and Information Science‖ as a search term in the All field tag fetched 387 records and the period of coverage from 2008 to 2016. The downloaded data were analyzed using MS Excel and VOS Viewer software applications. The analysis revealed that there are 160 authors from among 35 countries; 112 journals; 7 types of documents; 160 institutions; 1931 times cited by local and global references. 65.37% of publications are scholarly articles. The highest productive year is 2015 (Citation -183) and lowest is 2008 and 2009 (Citation-106 and 185). Of the 35 countries, India stands first, United State and Canada in the second and third places respectively. ―Annals of Library and Information Studies‖, ―DESIDOC Journal of Library and Information Technology‖, ―Library Philosophy and Practice‖ are the most productive journals involved in this study. Among the 160 authors, ―Mukherjee, B.‖ has earned the highest h- index value. ―University of Delhi‖ dominates other institutions in terms of a number of records.

Diabetes Mellitus type 2 is a group of disorders characterized by high glucose levels. Electrolyte abnormalities are commonly encountered in chronic diabetes mellitus type 2 patients. These patients usually have Potassium, Magnesium and Phosphate depletion. This study was conducted to investigate the electrolytes and lipid abnormalities in chronic type 2 diabetes mellitus in patients attending Rajiv Gandhi Institute of Medical Sciences and Hospital Adilabad. This study was conducted in the Department of General Medicine and Biochemistry, Rajiv Gandhi Institute of Medical Sciences [RIMS], Adilabad. The study included male and female subjects diagnosed with chronic diabetes mellitus type 2. Chronic diabetics were defined as those diagnosed with diabetes mellitus type 2 and on medications, for the duration of 5 years or more they were designated as Group I. Similarly age and sex-matched controls from the normal population were included in Group II as controls. Fasting blood samples will be collected in Vacutainer 10ml and serum fasting blood sugar, Serum Electrolytes and lipid profile will be estimated in fully automatic chemistry analyzer ‘Beckman Coulter Au 400’. The results obtained were recorded and analyzed using statistical software. Results: A total of 100 patients were included in the study divided into two groups Group I (diabetics) and group II (controls). The serum fasting blood glucose was measured in group I the mean values was 174.5 ± 25.6 mg/dl and in group II 96.5 ± 20.5 mg/dl the p values were found to be significant. The triglyceride levels as compared to controls the mean values in group I was 201.55 ± 35.8 mg/dl and group II was 190.5 ± 30.12 mg/dl the p values were found to be significant. The potassium levels were also elevated in the group I (diabetic) as compared to group II and the p values were found to be significant. It can be concluded that type 2 diabetes patients have abnormal lipid and electrolyte balance. The impaired mineral metabolism can result in disturbances in enzymatic activities, hormone secretions, and antioxidant levels. Therefore monitoring of these patients every 3 months will help in preventing the occurrence of long-term complications related to diabetes

A cross-sectional comparative study was conducted at Rajiv Gandhi Medical College, Kalwa, Thane, in Maharashtra state, India on 61 first-year MBBS students to compare the scores obtained by students in Objective Structured Practical Examination (OSPE) with that obtained in Traditional Practical Examination (TPE). In the TPE, each student performed red blood cell count, which was followed by viva-voce on the same procedure and marks out of 30 were assigned by the examiners. Students were oriented regarding OSPE and the marking system. At the “procedure station” of the OSPE (maximum marks = 20), the examiners were provided with a pre-validated checklist containing 10 steps for performing red blood cell count within an allotted time of 10 minutes. Two marks were given for correct performance of each step mentioned in the checklist. At the “question station” (maximum marks = 10), students had to write answers to 10 short-answer type questions carrying one mark each. The total marks obtainable during OSPE were out of 30. The mean OSPE score was 23 +/- 2.41 (95% CI: 22.40 – 23.60) while that for TPE was 17 +/- 3.58 (95% CI: 16.10 – 17.90). The difference in the mean OSPE and TPE scores was highly significant (Z=10.859; p<0.00001). The gender difference in TPE scores was statistically significant (p=0.017) but that in mean OSPE scores was not significant. Although the stations where most students committed identical mistakes were noted and feedback regarding their performance was given, extra training may be required for few students with lower scores. Periodically conducted faculty development programmes would assist in creating a pre-validated OSPE question bank.

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.

This is a theoretical paper with a charge to examine the scope and character of gender equality in the education systems of Uganda, Rwanda and South Sudan through a review of cross-national literature using feminist lens to interpret their connotations. While Uganda and South Sudan have invariably sought to enact affirmative action geared at achieving increased access for girl children, Rwanda has by and large focused on shifting from affirmative action to more holistic genderresponsive strategies in its crusade. This, perhaps, is the most convincing notion of salience among the three East African countries; confirming that formal opportunities for equal treatment of girl children ensure neither a shared starting point nor equal outcomes because of different cross-national milieus of change. In Uganda, the flagship of government initiative is the 1997 UPE which has since its launch spurred a big rise in the number of school girls across the country. The extension of the free education policy to 12 years represents Rwanda‟s best bid to attain gender equality; while the Go to School Initiative is South Sudan‟s rarest case of success in promoting access and participation but remains largely embryonic and sporadic. Cultural thinking, economic insecurity and social disadvantage immensely affect the way poor and rural households decide about investing in their girl children‟s education. There is need, therefore, to emphasize the intrinsic developmental value of education over and above the compulsion for productivity and employability. It is audaciously mistaken to establish that gender inequality could be altered by education or within the education system without restructuring sexual division of labour in the home and the market at large. To achieve gender equality in their education systems, Uganda, Rwanda and South Sudan must decode the cultural capital of their social classes and use that knowledge to empower women and girl children at the family and community levels while schools offer prospect. If these initiatives could be further institutionalised, resourced, and embedded in durable policy visions, it is possible for schools to become standard for broader societal transformation.

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

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