Neonatal thrombocytopenia is one of the most common hematological problems encountered in the NICU. We designed a study to determine the frequency, etiological profile, predisposing factors of thrombocytopenia in our NICU. The clinical impact of thrombocytopenia and its influence on the neonate's outcome were also studied. Methods: 179 consecutive NICU admissions in a 6 month period were included in our study. The subjects were grouped into 3 cohorts based on their platelet counts and their association with various variables was studied. The efficacy of the treatment protocol practiced for thrombocytopenia was evaluated. The neonates were followed up over a period of 6 months. To assess the prognostic value of severe thrombocytopenia; 12 variables that were significantly associated with poor outcome in the univariate analysis including low platelet count, along with other variables that are known to be associated with a poor outcome in NICU graduates, were subjected to multiple logistic regression using SPSS 13.0. Results: The prevalence of thrombocytopenia in our NICU was 39%. Septicemia was the common etiology. Maternal PIH, age at presentation, NEC, DIC, candiduria and assisted ventilation were identified as the predisposing factors. Severe thrombocytopenia was independently associated with a poor outcome based on multiple logistic regressions. Conclusion: Neonatal thrombocytopenia is far more common in our NICU as compared to that of the western studies. Septicemia is the most common cause. There are various predisposing factors for neonatal thrombocytopenia. Severe thrombocytopenic neonates are more likely to bleed and have a prolonged clinical course. Severe thrombocytopenia can be used as a prognostic indicator in sick NICU graduates. Fresh whole blood transfusion is a good alternative to platelet concentrates in the treatment of severe thrombocytopenia

A huge malignant tumour of breast for radiologists turned out to be a rare benign tumour. An ordinary tumour in an extra ordinary location in 80 year old female! Pleomorphic adenoma in breast was mistaken for a malignant tumour and radical surgery was performed. Hence, clinicians, radiologists and pathologists should be aware of this rare tumour and its clinical, mammographic and variable histological appearances, in order to avoid misdiagnosis and an unwarranted radical surgery.

One of the fundamental rights the FDRE Constitution acknowledges is the freedom of political party membership. To this effect, the Revised Political Parties Registration Proclamation, which regulates the details of political party membership, allows a political party member to withdraw from membership at any time. It does not provide for any formality. However, the Cassation Bench of the Federal Supreme Court has decided in Unity for Justice and Democracy Party v Blue Party (File No.112091, decided on 06 May 2015 (Miyazia 28, 2007 E.C.) that a political party member cannot withdraw and be a member of another political party without notifying the former political party in writing. This case comment examines the appropriateness of this decision from the perspective of the right to political party membership. The case comment analyses the constitutional and legal provisions pertinent to the right to political party membership in Ethiopia. Relevant provisions of international human rights instruments are also explored. To share a lesson from comparative experience, the experience of the Israeli and Kenyan legal systems is examined. This author argues that the law does not require a written withdrawal notice. This enables a political party member to terminate his/her membership not only with written withdrawal notice rather by all other possible ways, including by taking new membership in another political party.

Lupus Miliaris Disseminatus Faciei is an idiopathic granulomatous skin disease affecting the face. It is also called as Acne agminata or Facial idiopathic granulomas with regressive evolution. It has a predilection for lower eyelids, forehead, nasolabial folds and perioral areas. Caseating as well as non- caseating epithelioid cell granulomas are identified on histopathological examination therefore differentials such as tuberculosis, sarcoidosis, granulomatous rosacea and other granulomatous disorders should be ruled out. A thirteen year old female presented with multiple papules perinasally and periorally around chin. A skin biopsy was performed from the lesion and sent for histopathological examination. On microscopic examination, a granulomatous reaction pattern was seen in the dermis. X-ray chest was unremarkable. Mantoux test was negative. Apple- jelly nodule like appearance was observed on diascopy. A diagnosis of LMDF was rendered on histopathology after clinical correlation. The diagnosis of LMDF should be kept in mind in case of papular eruptions on face not responding to antitubercular treatment. Mainstay of treatment is tetracycline and oral isotretinoin.

The legitimacy of criminal law is essential and ambiguous foundation of the criminal system. The notion of legitimacy should be legally grounded. The law has to be rightful and its applications needs to be legitimate. The controversy legitimizing criminal law has become an issue not only among politicians and lawyers, but also among academicians. This study has investigated the legitimacy of the criminal law. The study also investigated the relationship between constitution and legitimacy of the criminal law. The findings indicated that constitution is an essential component of criminal law legitimacy. The authorities to legitimize their decisions need to abide by the written constitution of the country. This study also investigated the important of communication and interaction between components of society to comprehend the legitimacy of the criminal law. The legitimacy of the criminal law is also important to overcome conflicts and crises. This study identified that law enforcement does not resolve criminal issues as a whole, but it’s an instrument to minimize the danger of its escalation. It will help the law enforcement to be respected and considered by the wider society

Streptococci cause a diverse array of infections. Changing trends in Streptococci causing invasive disease was noticed. This analysis aims to elucidate epidemiological trends amongst various invasive streptococcal diseases (IPD). Surveillance data was abstracted from the Electronic microbiology System for confirmed cases of alpha and Beta-hemolytic streptococci. A total of 91 isolates of streptococci were included. Streptococcus mitis 23 (23.9 %), was the most common isolate followed by Streptococcus agalactiae (Group B) 20 (20.8%) Streptococcus pneumoniae 14 (14.5%) Streptococcus pyogenes (Group A) 7 (7.29%), Streptococcus salivarius 7 (7.29%) and 20other different streptococcal species including (Streptococcus gordonii 5 (5.2%), Streptococcus parasanguinis5 (5.2%), Streptococcus sanguinis 4 (4.1%) Streptococcus species 1 (1%) Streptococcus anginosus 1 (1%), Streptococcus gallolyticus 1(1%), Streptococcus infantarius 1 (1%), Streptococcus intermedius 1 (1%), Streptococcus thermophilus 1 (1%)). Of 91 isolates identified cases of invasive disease, Children ≥1-5 years had the highest incidence for Invasive streptococcal disease (20.4%), Among the IPD, Bacteremia was the most frequently reported clinical manifestation for 64 (70.3%), followed by Invasive soft tissue infection 18 (19.7%) then meningitis 9 (9.8%). There is high prevalence of invasive disease in the study population.

Adverse Drug Reactions (ADRs) are scantly reported with poor contribution by healthcare professionals worldwide and in particular in developing countries. The aim of this study was to assess the knowledge and awareness of ADRs reporting and pharmacovigilance system among doctors and nurses in KLEs Tertiary care hospital Belagavi. A questionnaire was designed addressing; awareness of ADRs, knowledge of pharmacovigilance system, availability of ADRs reporting system. The questionnaire was distribute to doctors (n=160) and nurses (n=140) working in hospital. Completed questionnaires were collected, data were analyzed and data were expressed in number as well as percentage. Of the 300 questionnaires circulated, a total of 107 doctors and 107 nurses responded. The percent of the respondents who accepted to enroll in the study was 66.8% of doctors and 76.4% of nurses. Most of the respondents were unable to correctly define the pharmacovigilance term, but they were aware of ADRs. The awareness of the national pharmacovigilance system among doctors was 32.5% and nurses were 37.9%. (42.5%) doctors and (54.3%) nurses follow the reporting system to pharmagovigilance center. Our study has demonstrated a lack of knowledge and awareness of pharmacovigilance and ADRs reporting among healthcare professionals in hospitals. The poor knowledge of ADRs reporting emphasized the urgent need to implement the appropriate strategies to improve the awareness ofpharmacovigilance practices and ADRs reporting in our hospitals

The first successful nephrectomy was performed by the German surgeon Gustav Simon on August 2, 1869 in Heidelberg. There are various indications for this procedure, such as renal cell carcinoma, a non-functioning kidney (which may cause high blood pressure) and a congenitally small kidney. Study period was between June 2014 and March 2018. Total nephrectomies done during this period were 146. Nephrectomies constituted 0.94 % of all the specimens received. Among them 94 were males and 52 were females constituting 64.4 % males and 35.6 % females respectively. In this study, among the 146 nephrectomies, majority was non-neoplastic lesions (114 cases) and 32 cases were neoplastic lesions. Among the 19 cases of renal cell carcinoma, majority cases were of clear cell pattern (8 cases), clear cell with papillary pattern, clear cells with anaplastic areas, chromophil type and chromophobe type, renal cell carcinoma –sarcomatoid variant. Occurrence of various pathological conditions such as infective, inflammatory and neoplastic lesions is common and incidental. Early diagnosis and treatment of the infective and inflammatory conditions will save the kidneys. In case of neoplastic lesions early identification of clinical features and proper usage of various diagnostic modalities will limit the Nephrectomies.

Abstract: The discovery of precancerous breast lesions has increased considerably with the generalization of screening. There are several classifications, the most used is that of Tavassoli and Al (adopted by WHO) which classifies intra-lobular breast neoplasia into three grades: LIN1, LIN2, LIN3. Lobular neoplasias are considered indicators of risk of invasive cancer. Progress in immunohistochemistry, cytogenetics and molecular biology, made it possible to better understand these lesions separating lesions that can be considered as simple breast cancer risk markers (LIN 1, LIN 2, LIN 3 type I) from those that correspond to true precursors of breast cancer (LIN 3 types II and III ). The management varies according to the histological type. The early diagnosis of these lesions thanks to the screening as well as a good management could help reduce the incidence of breast cancer.

India has the World’s largest burden of tuberculosis and approximately 15- 20% of these cases have extrapulmonary disease (EPTB). The diagnosis of tuberculosis from tissue specimens is usually made by histopathological examination (HPE). However, histopathology does not always give specific findings and needs more than one week for final reporting. In 2013, WHO endorsed Xpert MTB/RIF assay for the rapid diagnosis of EPTB. In the present study the efficacy of this assay to diagnose tuberculosis from tissue specimens was assessed, taking composite reference standard (CRS) as reference standard. A total of 63 consecutive specimens of EPTB (June 2016 to May 2017), one showed the growth of non-tubercular mycobacterium on culture and was excluded from the study. Among the remaining 62 specimens, the most common were female genitourinary specimens (endometrial biopsies)- 30.64%, followed by vertebral tissue 29.03% and bone tissue 9.68%. The positivity shown by smear microscopy and HPE was 12.9% each, culture 14.52% and Xpert MTB/RIF assay 32.26%. The sensitivity and specificity of Xpert MTB/RIF assay in comparison to culture were 100% and 79.25% respectively. Whereas, CRS which includes smear microscopy, culture, histopathological, clinical and radiological findings, as reference standard, Xpert MTB/RIF assay showed sensitivity 64.52%, specificity 100%. This study suggests that Xpert MTB/RIF assay has good diagnostic potential for the rapid diagnosis of tuberculosis in tissue specimens, which could help in the timely initiation of antitubercular treatment and prevention of progression to irreversible changes.

There have been conflicting reports by researchers on the effect of aqueous leaf extract of Ocimum gratissimum (OG) on haematological parameters This study was carried out to evaluate the dose-dependent effect of OG leaf extract on some haematological parameters in wistar rats. Twenty-four male rats were randomly assigned into four groups of six rats each. Group 1 was a control while groups 2, 3 and 4 were test groups (T1 – T3) and were given 450mg/kg, 800mg/kg and 1800mg/kg respectively of OG leaf extract daily for 30 days. All rats had free access to water and rat chow. Results showed a significantly decreased RBC count in T2 (p<0.05) and T3 (p<0.01) compared with control. Platelet count and PCV were significantly decreased in T3 (p<0.05) compared with control. A significant increase in total WBC count was observed in T1 (p<0.05) and T2 (p<0.01) when compared with control. A significant reduction in neutrophil count in T1 (p<0.05), T2 (p< 0.05) and T3 (p<0.01) compared with control was observed. Lymphocyte count was significantly increased in T1 (p<0.05), T2 (p<0.01) and T3 (p<0.01) compared with control. There was no significant difference in MCV, MCH and MCHC in the different groups. In conclusion, aqueous leaf extract of Ocimum gratissimum caused reduction in RBC count, PCV, platelet count and neutrophil count but caused increases in total WBC count and lymphocyte count

Synovial sarcoma is a translocation associated sarcoma characterized by SS18 – SSX1/2 fusion. It is one of the common adult soft tissue sarcomas predominantly affecting lower extremities. In resource poor settings, exact characterization by molecular methods may not be feasible always. In our study we attempted to study the clinical profile, histomorphology and immunoprofile of cases diagnosed as synovial sarcomas. Forty two cases diagnosed as synovial sarcomas based of presentation, histomorphology and immunopanel were analysed .The median age of presentation was 26 years with male to female ratio of 1.5:1. Majority of the sarcomas were of monophasic type (83%) with predominant hemangiopericytomatous pattern (67%) followed by fascicular pattern (48%). Tumor size was greater in adults older than 20 years when compared to younger age group. Tumors with large areas of calcification were seen with significantly low mitotic index.

The incidence of inguinal hernia is very common especially in older individuals. Often patients are unaware of the presence due to absence of any symptoms unless detected accidentally or detected in those causing presence of pain or other symptoms. The anterior open inguinal hernia repair with mesh was described by Lichtenstein in 1989. This tension free operation has become popular. We in the present study operated on the patients with uncomplicated unilateral inguinal hernia with Lichtenstein tension free technique under Local Anesthesia and Spinal Anesthesia to evaluate their outcomes. Methods: This prospective study was conducted in the Department of General Surgery, Prathima Institute of Medical Sciences, Naganoor, Karimnagar. A total of 74 patients admitted to the hospital with the diagnosis of uncomplicated inguinal hernia were included in the study. They were divided into two groups Group I (LA) included 36 patients and group II [GA] 38 patients. The investigations required as routine for diagnosis and to test the sensitivity to the local anesthetic night before surgery. Lichtenstein tension free hernioplasty is performed irrespective of type of anesthesia. The postoperative pain was measured with the Visual analogue scale (VAS) at 4h, 8h, 12h & 24h. Results: Mean time taken for duration of surgery in LA group is 58.8 + 6.02 minutes & in SA group is 56.6 + 6.74 minutes. P = 0.246 not significant. Mean time spent in operating room in LA group is 68.1 + 6.35 minutes & in SA group is 76.4+6.52 minutes with a significant P value of <0.01. The mean VAS score at 4h, 8h, 12 h, & 24h for LA group was low when compared to the SA group. The maximum VAS score was observed at 8h in both the groups and less in LA group at 3.13 ± 1.26 as compared to SA group 4.31 ± 1.66 at 12 hours also VAS was less in LA at 1.97 ± 1.02 as compared to SA 3.15 ± 1.88. Conclusion: From our study it is observed that Lichtenstein tension free hernioplasty done under local anesthesia offers following several advantages over spinal anesthesia and it is Safer even in the patients with medical comorbidities and on antiplatelet therapy. Therefore local anesthesia may be considered as the anesthesia of choice for Lichtenstein tension free hernioplasty for an uncomplicated, primary, inguinal hernia

The exploration of antibiotic and antiseptic resistance in the hospitals are happened by various reasons including continuous usage of same antiseptics and disinfectants for surface cleaning, inappropriate and misuse of antimicrobials, No follow up of the patients and discontinuation of the course of drugs. This may create a demand for new and long term effective drugs against antibiotic resistance. Comparing to the chemicaly fabricated drugs, metals are considered as the better choice of replacement. From the ancient times, the basic understanding of antimicrobial properties of metal particles like silver, mercury, copper and arsenic are quite available in practice; but their scientific evidences are lacking. Thus this study may provide some information related to the determination of in vitro antibacterial activity of various concentrations of silver solution against several bacterial pathogens isolated from wounds. The evident record of this study highlighted that 10-2 mM silver solution showed maximum bactericidal effect on Staphylococcus aureus, Providencia rettigeri and Pseudomonas aeruginosa with 17mm, 16mm and 16mm inhibitory zone respectively. Other test bacterial species also inhibited but not upto the mark. We may recommend the high concentration of silver solution in the form of antiseptic spray as surface bactericidal mask for wound management.

This study is aimed at evaluating the outsourcing program at PT. Pelindo II Bengkulu, whether the outsourcing program at PT Pelindo II Bengkulu provided benefits to the company, for the outsourced employees themselves, and for the absorption of the workforce in general. The study was conducted by applying the evaluation research by using the Context, Input, Process, Product (CIPP) model approach. The source of the data used in this study was from company outsourcing users, outsourcing provider companies, and the outsourced workforce itself. The instruments of the study were observation, deep interview, questionnaires, and documentation. Furthermore, the data were analyzed descriptively through discussion and triangulation. Elements that became aspects being evaluated in this CIPP model approach were C (Context evaluation), I (Input evaluation), P (Process evaluation), and P (Product evaluation). Was it useful for the outsourcing program at PT Pelindo II Bengkulu, for outsourced employees, and for the absorption of workers in general?. This evaluation study resulted in findings that outsourcing program had given positive impact for cost efficiency at PT Pelindo II Bengkulu. This outsourcing program did not give definite future for the outsourced employees. The outsourcing program had provided wider employment opportunities for job seekers and many of the type of work outsourced by PT. Pelindo II Bengkulu did not meet the provisions in the Regulation from Minister of Manpower and Transportation of the Republic of Indonesia number 19 Year 2012 regarding the terms and conditions of delivery of part of the implementation jobs to other companies.