Diabetes Mellitus is the most common endocrinological condition. We can see complications as a result of the changes in microcirculation and tissue collagen structure. In our study; we aimed to discuss the clinical features and wound evaluations of the patients who applied to our clinic with diabetic hand wound, as well as their treatments and results. Patients with diabetic hand wounds who applied to our clinic between 2013-2015 were included. Demographic data, type of diabetes, characteristics of hand wounds, laboratory values, culture results, abscess involvement, treatment methods, and treatment results of the patients were obtained. Nine of the 29 patients were female and 20 were male. The mean age was 63.62 ± 14.12. 22 patients had the wound in their right hand while 7 patients had it in the left hand. While 25 patients had finger involvement, 2 had volar part involvement and 2 had wounds in the dorsal part of the hand. 19 patients were treated with debridement and 10 patients were amputated. Flaps / grafts were applied to 5 of the patients. 8 patients had high sedimentation rates. The mean C-reactive protein value was calculated as 43.94. The mean HbA1c of the patients was 8.70 ± 1.74. The wounds of all 29 patients were treated successfully. Patients should be careful while they are using hand tools, cutting nails, and should wear protective equipment. Strict blood glucose control, aggressive debridement, and antibiotics in the treatment of these wounds can reduce the risk of amputation

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.

Marketing efficiency as a concept is strongly linked to many of the core organizational results, such as long-term growth, stability, customer satisfaction, competitive advantage, and strong market orientation. Marketing effectiveness depends on the company's goals. Due to the growing demand for marketing professionals, one needs to focus on a system where both short-term and long-term financial impact can be measured on the company's market investments. Marketing effectiveness measurement is a business process that shows the results of specific marketing decisions. The effectiveness of marketing activities should be defined as the return on the funds invested in these activities.

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.

It is not hard to find plenty of children’s poetry in ancient China, exhibiting children’s creative contents and literary skills. Taking examples mainly from Fifty Selected Children's Poetry in Ancient China: English Translation and Appreciation, this paper applied the Three-Level Criteria of poetry translation by Dr. Wang Feng to analyze several English translations of children’s object-chanting poetry in ancient China. In children’s object-chanting poetry translation, at the macro-level, the criterion is Harmony; at the middle level, the theory of “resemblance in style, sense and poetic realm”; at the micro-level, the criteria of Eight Beauties, centered on the beauty of emotions and images. Based on these analyses, this paper aims to test the validity of the "Three-Level Criteria of poetry translation" and hopes to guide and promote the theoretical and practical studies on the English translation of children’s poetry in ancient China from a new perspective.

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.

T-Cash is one of the Pioneers of provider-based e-money services. Although T-Cash is declared successful, consumers are still afraid to use it Because Cultivating trust and attracting customers will save money on apps is not an easy thing. The purpose of this research is to know the result of testing the influence of information quality, security and quality of T-Cash e-money payment service application system to customer satisfaction and customer retention and partially simultaneously. This research uses AMOS Structural Equation Model (SEM) software. From the results of the data analysis can be known variable quality of information, security and application system Significantly Affect quality customer satisfaction and retention and customer satisfaction itself Significantly variable variable influences customer retention.

β-Lactam antibiotics are commonly used to treat bacterial infections. Increased use of antibiotics, particularly the third generation of cephalosporins, has been associated with the emergence of ESBL producing bacteria, most commonly in E. coli. And Klebsiella pneumonia. Infection due to ESBL producers range from uncomplicated urinary tract infection to life threatening sepsis. This study was undertaken to assess the prevalence of ESBL producing E.coli and Klebsiella isolates. Patients taking treatment in P.D.U. Hospital and Medical College, Rajkot- a tertiary care hospital in Gujarat, India, were included in study. During the half year period from July 2014 to December 2014, a total of 600 E. coli and Klebsiella isolates from various clinical specimens were included in the study. The isolated organisms of E. coli and Klebsiella were characterized for their production of ESBL. Out of 600 E. coli and Klebsiella isolate, E. coli were 224 (37.3% and Klebsiella spp. 376 (62.7%). The overall rate of production of ESBL (by phenotypic confirmatory test with double disc diffusion method) in total isolates of E. coli and Klebsiella spp. is 22.5% (135/600). The rate of production of ESBL in E. coli is 29.9% (67/224) and in Klebsiella spp. is 18.1% (68/376). ESBL producing E. coli and Klebsiella showed high prevalence in present study. Routine laboratory testing for ESBL is needed in order to optimize antibiotic management to reduce ESBL associated morbidity & mortality.

The investment value that has been made by South Korea in Indonesia has increased, companies in the field of textiles and shoes require more female workers than men. Workers' loyalty will have a positive impact on the workers who can be affected by the increase in employee performance in developing the company. The purpose of this study is to analyze the factors that influence the loyalty of female workers who work in Korean companies. This research method is quantitative with data collection techniques using questionnaires, interviews, and direct observation to South Korean companies in Indonesia. The statistical test used is Regression Analysis. The results of this study that work discipline affects loyalty, career development influences loyalty, work motivation affects loyalty and workload has no effect on loyalty.

This study examines the relationship between monetary aggregates and economic growth with evidence from Nigeria. It examines the extent to which narrow and broad money supply relate to Nigerian Real Gross Domestic Product. Data collected were analyzed using multiple regression. The result of the study shows though broad money supply (M2) has a salutary effect on the performance of the economy as shown by the positive relationship it exhibits, the relationship is not such that monetary aggregates can significantly contribute to the performance of the economy. The paper recommends that since monetary aggregates are weak in achieving growth in the Nigerian economy, a combination of monetary and fiscal policy measures , perhaps will achieve the desired objective of growing the economy.

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.

The mouth is regarded as a mirror and the gateway to health. Various dental treatment modalities frequently require appointments, which are more than one in number for completion of the entire treatment program. Missed dental appointments are an issue which has been noticed for years but very little research has been conducted around it. To assess various factors responsible for missed dental appointments among the patients attending a dental college. A cross-sectional study was conducted among the patients attending various departments of the college. A sample size of 960 was calculated based on the results of the pilot study and the patients who missed their appointment at least once during their treatment procedures were included in the study. A self-structured 19 item questionnaire was used to measure various factors responsible for missing the appointment. The collected data was subjected to statistical analysis by using SPSS version 21.0. Among 960 patients, 53% were females and 46% were males. Various reasons for not attending recall were assessed in patient’s perspective and college perspective. Lack of time (63%). fear (62%) were cited to be the most common factors for not attending recall in patients perspective and inconvenient appointment timings (47%) and dissatisfaction with the reception area(44%) were cited to be the most common factor for missing the appointment in college perspective. This study concluded that patients who miss appointments cite the most common reason as lack of time, fear, lack of transportation inconvenient appointment timings. The key in dealing with the issue of missed dental appointment lies in altering patient’s psychology during the first appointment. Counselling and motivation is required to be done at first dental visit to reduce the chances of missed appointment.

Abstract: Several new biochemical and hematological parameters are available to diagnose and monitor alcoholic liver disease (ALD), but none are independently sufficient for the purpose. Serum enzymes - Alanine aminotransferase (ALT), Aspartate aminotransferase (AST), Alkaline phosphatase (ALP), Gamma glutamyl transferase (GGT) and AST:ALT ratio (De Ritis Ratio) are conventionally used as markers for diagnosis, treatment, prognosis and monitoring of ALD, based on their correlation with values before and after treatment or abstinence from alcohol intake. We wanted to establish the utility and affordability of estimation of these serum enzymes in ALD. To assess the levels and analyse the costs of estimation of conventional serum liver enzymes in ALD. After IEC clearance, this hospital based study was carried out on 30 male patients of diagnosed ALD and 30 normal control (non-alcoholic, healthy male) subjects between 18-65 years without history of liver disease, HIV, upper gastrointestinal bleeding, shock and/or ischemia to the liver, hepatotoxic medication use or exposure to high levels of environmental hepatotoxins, renal disorders, diabetes mellitus, hypertension. Serum AST, ALT, ALP, GGT levels were estimated using commercially available Roche diagnostic kits and fully automated biochemistry analyser (eCOBAS 6000 c501, Roche). Enzyme levels were expressed as Mean ± SD in IU/ml. Statistical analysis of differences in Means was done with Unpaired Student’s ‘t’ test, using GraphPad Quickcalcs online software, considering significance level as P < 0.05 at 95% confidence interval. Cost calculation of all the tests was done. Serum AST, ALT, ALP, GGT levels were highly significantly raised in ALD patients compared to healthy controls. De Ritis ratio was greater than 2 in 70% ALD patients. Cost calculation revealed that each patient had to pay a total of Rs 80/- for the tests. Conventional serum liver enzyme estimation and calculation of De Ritis ratio are useful and affordable diagnostic and prognostic markers in ALD.

The parasitic weed Striga hermonthica poses a serious threat to sorghum production in Northern Cameroon. To evaluate the response to S. hermonthica of 24 genotypes of rainfed sorghum and the effect of sodium carbonate on this parasite, field and pot experiments were conducted at Touboro (North Cameroon) in 2016 and 2017. In pot and in field, under striga infestation, results showed varietal responses of sorghum for the number of emerged Striga, the height of sorghum, the stem diameter, the number of leaves per plant, the panicle weight and the grain yield. Globally, Striga infestation significantly reduced the height, the stem diameter, and the number of leaves, the panicle weight and the grain yield of sorghum accessions by 28.94%, 19.54%, 17.78%, 28.24% and 44.17% respectively. Application of natural sodium carbonate salt reduced significantly the emerged Striga and the host plant damage by 74.29% and 41.94%. Under Striga infestation, sodium carbonate also increased the growth and yield sorghum accessions. Among the 24 studied genotypes, complete resistance was no recorded, but landraces LMO-LT18, LMO-LT22, KW-CP09 and LMT-21 appeared as the most resistant and tolerant to S. hermonthica. Combination of sodium carbonate with resistant and tolerant genotypes should be investigated as a major component of integrated packages to the effective control of Striga on sorghum in northern Cameroon.

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.