This study aims to examine and analyze the influence of transformational leadership, organizational culture, and work motivation on employee performance of PT XYZ. The sampling method used is proportional random sampling. From a population of 100 employees with a sample of 80 employees. The method of analysis used in this study is multiple linear regressions. The results showed that transformational leadership, organizational culture, and work motivation together (simultaneously) have a significant effect on performance. Partially transformational leadership and organizational culture have a significant positive effect on performance. Organizational culture and work motivation have a significant positive effect on performance.

There is need for more of scientific studies on the validity of traditional neurological teaching of clinical sign. Many textbook mention several cerebellar signs, but what the evidence base for these mention statements? A thorough search in the literature did not found the incidence of these cerebellar signs in cerebellar disorder and there validity. To assess sensitivity and positive predictive value of each cerebellar sign in cerebellar disorder. Residents in the department of medicine asked to examine healthy control or patients in a random order without giving them any information about the subject. Inability to do Tandem walking, Ataxic-gait, intention tremor, dysdiadochokinesi, dysarthria are having higher sensitivity while hypotonia and pendular knee jerk have lower sensitivity. Out of these 12 cerebellar signs, except Hypotonia and pendular knee jerk all were having statistically significant association.

The Scarlet Letter has aroused people‟s attention since its publication. The analysis of the protagonist, Hester Prynne in the novel, has always been a heated topic at home and abroad. Scholars have interpreted Hester Prynne from many perspectives like Archetypal Criticism, Modernism or Feminism, especially eco-feminism. Therefore, this article tries to extend the previous‟ studies in terms of Androgyny. Based on the theory of Androgyny, this article aims to analyze both the femininity and masculinity of Hester Prynne, which is to reveal the deconstruction of binary opposition in the traditional viewpoint of sexuality. Hester Prynne's femininity can be interpreted from her feminine charm and maternity, while her masculinity can be analyzed from rebellious spirit and survivability. Besides, this article explores the influence of Hester's androgynous characteristics on herself, Dimmesdale, Chillingworth and other people around her, which is to embody Hester's self-growth. As a result of her innermost androgyny, Hester grows from an unworldly young woman to a strong-willed, independent and mature woman.

Postpartum Hemorrhage in atonic uterus with ‘C’ section is an important complication and commonly encountered condition. We in the present study tried to evaluate the effectiveness of B-Lynch suture to control PPH in atonic uterus. The study was conducted on n=100 patients in the Department of Obstetrics & Gynecology, Rajiv Gandhi Institute of Medical Sciences [RIMS] Adilabad during Feb 2016 to Dec 2017. 50% of patients were in age groups 20-25 years and 26% belonged to age groups 25-30 yrs and 24% were in the age group of 30- 35 yrs. Primi gravida was in 75% of the cases and 25% of cases were second gravid. Hydramnios was present in 20% of cases PET was in 25% of cases, prolonged labour was in 30% of cases and Previous LSCS and PET was present in 25% of cases each. In 76% of cases no blood transfusion was required, 15% of cases required 1 unit blood transfusion, and 9% required 2 units’ blood transfusions. The complications due the procedure were nil and mortality was nil. Conclusion: The B-Lynch suture is still one of the best methods to control Postpartum Hemorrhage PPH in atonic bladder especially in low resource settings. If used properly it can control PPH without need of blood transfusions and complications and the procedure also preserves the uterus functions and future fertility

Recent economic developments are more dependent on the value created by intangible assets than tangible company's assets. Intangible assets in question are intellectual capital that is recognized as the basis of individual, organizational, and general competition in the 21st century. The rapid global economy and technological innovations that have led to tough competition in the business world make IC creation, management, measurement, and evaluation an important indicator in improving company performance that will affect the value of the company in the future. This study aims to determine the strong influence of intellectual capital on company performance, and how the influence of human capital on structural capital and relation capital by distributing questionnaires to 100 employees of banking companies in Jakarta for middle and upper positions. Approaching method used is Partial Least Square (PLS). Based on research that has been conducted, it can be concluded that human capital has influence on relation capital and structural capital. Similarly, human capital and relation capital has a significant influence on company performance, but structural capital doesn’t have significant effect on company performance.

It is now over four decades since the idea of a New International Economic Order (NIEO) was proposed. Same is still been popularized, applauded tacitly by the developing Nations and seen as the way to go by the international community. This work seeks to examine the proposed new economic order and its possibilities and challenges. The analysis indicates that no significant progress has been made in the demands listed as contributing to the NIEO, especially, the ones that are germane to the heart of the present system. They are in the areas of money and finance; integrated programme and terms of trade; technology and TNEs; sovereignty and equal rights; and co-operation among developing countries. It is important to state that as long as these basic issues are not resolved and a consensus does not emerge concerning them. The possibility of a new international economic order will continue to gloom.

This study aims to determine the relationship between employee motivation and the level of urban services, especially the service of urban garbage at the Environmental Office of Gorontalo City. The research method using descriptive method, data collection techniques using questionnaires and direct observation in the field. While data analysis using regression analysis technique and correlation with research scope on employee motivation dimension and service level of urban area. The result of the research showed that employee motivation motivation 57,14% employee have high work motivation with average score 81,8 and 42,86% employee have low work motivation. While in terms of urban service level shows that as many as 27.14% of employees stated high service level with an average score of 63.86 and as many as 71.43% said stating employees the level of service is as well as 1.43% said stating employees low service levels . correlation coefficient r = 0.346, there is correlation between employee motivation and level of service of urban with weak category. Regression equation Y = 31.4 + 0.397 X or contribution / influence of independent variable of employee motivation to dependent variable of urban service level equal to coefficient b = 0,397. There is a positive relationship between employee motivation and the level of urban services but the motivation to the employees of the Gorontalo City Environmental Office has little effect on the level of urban services.

Coronary artery disease (CAD) is currently one major cause of death in the world [1, 2]. CAD is mainly caused by atherosclerosis, which is considered as a chronic inflammation in response to cholesterol accumulation in the arterial wall [3]. Therefore, biomarkers that can predict the presence for early atherosclerotic process and CAD are desirable. Lipidomics is playing vital role in development of atherosclerosis and in cardiovascular disease. Various inflammatory markers and lipid biomarkers are playing role in diagnosis of CAD. Inflammatory biomarkers such as CRP, cytokines [interleukin (IL)-1, IL-6, IL-8, monocyte chemoattractant protein-1 (MCP-1)], soluble CD40 ligand, serum amyloid A (SAA), selectins (E-selectin, P-selectin), myeloperoxidase (MPO), matrix metalloproteinases (MMPs), cellular adhesion molecules [intercellular adhesion molecule 1 (ICAM-1), vascular adhesion molecule 1 (VCAM-1)], placental growth factor (PlGF) and A2 phospholipases may have a potential role for the prediction of risk for developing CAD and may correlate with severity of CAD..Dyslipidemia is major cause of Cardiovascular disease. Ceramide a lipid biomarker is playing a emerging role in diagnosis of CAD, In this review we tried to focus role of Ceramide in diagnosis of CAD and to further risk stratify patients who may otherwise not receive treatment but would remain at high risk for a serious cardiac event. These are patients who could benefit from more intensive treatment, for example: a higher-dose statin, a nutritionist consult or formal exercise therapy. Cardiologists at Mayo Clinic are already routinely checking Ceramides using the new test.

Theoretically, the research will reveal, review and discuss the workshop management refers to the Regulation of the Minister of National Education of the Republic of Indonesia number 40 of 2008 in improving the students' work skills skill at SMK Negeri in Jambi Province. This research is a case study research using qualitative approach. The steps undertaken by the researchers starting from the pre-field, the stage of field work to the stage of field inspection. The result of the research reveals: SMK in Jambi Province has not carried out the full management functions and socialization of Permendiknas RI number 40 year 2008 not to the institution of SMK in Jambi Province so that its existence has not improve the quality of Education especially the work practice skill of students. Workshop management and Permendiknas RI number 40 year 2008 to improve students work practices skills through the provision of facilities and infrastructure workshop complete according to national standards. While the skills of vocational students working practices in Jambi Province still need to be improved in order to achieve the competency standards of national vocational graduates and prioritize the application of Permendiknas RI number 40 of 2008 by reviewing all related institutions from Directorate General of Ministry of Education to vocational institutions in Jambi Province.

Adjuvants are commonly used during general anesthesia in order to reduce the requirements of the general anesthetics. Dexmedetomidine is one of an important general anesthetic adjuvant used because of its useful properties like sedative, analgesic and anxiolytic. It has other important useful properties like cardioprotection, neuroprotection and minimal respiratory depression. We in the present study tried to evaluate the efficacy of dexmedetomidine in different concentration when used as an infusion during general anesthesia in patients undergoing routine abdominal surgeries. Methods: the study was conducted in Rajiv Gandhi Institute of Medical Sciences and Hospital [RIMS], Adilabad. The patients were selected from those undergoing abdominal surgeries. They were randomly divided into three groups. Group A (n=20) patients acting as controls received IV saline 10ml. Group B received Dexmedetomidine 0.5 µg/Kg/hr IV and Group C received Dexmedetomidine 1 µg/Kg/hr IV. Anesthesia was maintained with N2O to O2 mixture of 60:40. MAP values were maintained within 25% of the baseline values. Recovery times from tracheal extubation, modified Alderete score, VAS scores, tolerating liquids, and passage of flatus was noted. Results: The mean duration of surgery in Group A was 145.45 ± 20.06 minutes, mean duration of anesthesia was 180 ± 25 minutes. The mean duration of infusion of dexmedetomidine was 160 ± 20. For group B the values were 130.12 ± 24.75, 160.0 ± 22.0, and 140 ± 90 minutes respectively. The values for group C were 121.59 ± 18.16, 145 ± 26 and 125 ± 15minutes. The P values between group A and C were significant in Mean duration of anesthesia and mean duration of infusion. The time to suction catheter response was significantly higher in Group C. The modified Aldrete scores in Group B and Group C were found to be significant when compared to Group A similarly postoperative nausea and vomiting was significantly lesser in group C and VAS scores of pain were also significantly lesser in the Group C as compared to Group A and B. conclusion: Dexmedetomidine is low concentrations may be useful to provide sedation and mild analgesia at the same time preserving the cardiovascular and respiratory functions. Therefore dexmedetomidine when used as a general anesthetic adjuvant during routine abdominal surgeries reduces the sevoflurane and opioid requirements and results in better recovery of the patients.

The phenomena of labour migration from South Asia to GCC countries are result of structural changes in the demand and supply of labours in the GCC countries in the context of different time and space. The oil producing countries of Gulf Cooperation Council (GCC) is the largest destinations for South Asian migrant labourers. South Asian countries mainly India, Pakistan and Bangladesh are the largest source of origin of migrants in GCC Countries. The huge stock of temporary South Asian migrants led to largest inflow of remittances in origin countries. Among the South Asian countries; India is the largest source for supplying of migrant labourers in the GCC countries as well as top remittances recipient country. The labour migration from India to GCC countries is recent phenomena began with incident of oil boom in the GCC countries in 1973. In the initial phase of labour migration from India to GCC countries was dominated by Kerala but recently there are regional variations showed in the labour migration from India to GCC countries. In these entire discussion, paper attempts to present an analysis and overview of the nexus of migration and remittances in South Asian countries with special references to India.

Genes are the smallest functional units of the genetic system, which control the development and function of all organisms. A gene is a linear sequence of DNA that codes for a particular protein. Gene therapy is based on principle that a normal gene is inserted to compensate for a nonfunctional gene and abnormal gene can be repaired through selective reverse mutation. It uses purified preparations of a gene or a fraction of gene to treat diseases. Gene therapy can be used to treat wide range of diseases ranging from single gene disorder to multi-gene disorder. It has variety of applications in the field of dentistry like in cancerous and precancerous condition, salivary gland disorders, autoimmune diseases, bone repair, DNA vaccination, bone repair etc.

The study is centred on understanding the underlining factors influencing consumer’s choice in purchasing patterns. Contemporary consumers are believed to reflect elements of rationality and irrationality in their consumption preferences. So the study assessed the choice motives which prompt the patronage of some selected household items amongst university students. These items are phones, laptops and consumables. The students were randomly selected on gender basis. Assessed factors include peer influence, trends, affordability, advertorials, needs, lifestyle, health, religion, income and product packaging. Findings revealed that the influence of rationality and irrationality are inherent in consumer behaviours, but personal interest of consumers at a particular point in time takes precedence.

An analysis of 129 cases of vocal cord polyps was done in this study. It was most often seen in middle aged persons during third, fourth, and fifth decades of life. Maximum incidence was in the 5th decade. The youngest of the patient was 26 years of age and the oldest was of 45 years, with the mean age of 36 years. Vocal cord polyps were found predominantly in males (86%), with a male and female ratio of 6.1:1. In all 129 cases, the lesions were unilateral and mostly situated in the middle of the vocal cords. Smoking (68.2%), vocal abuse or misuse (62.8%), and chronic respiratory tract infection (30.2%) were the main aetiological factors. There were no dysplastic changes in the epithelium. The treatment options for vocal cord polyps included both non-invasive and invasive techniques. Non-invasive techniques included conservative therapy with voice rest, steam inhalation, antiallergics, antibiotics, and antireflux drugs. Conservative treatment was considered as an option in vocal cord polyps which were small and of recent onset. Invasive technique was a combination of surgery and vocal rehabilitation. Conventional microlaryngeal surgery was ideal for the treatment of vocal cord polyps. In 82 cases (63.6%), the histopathological picture was of fibroangioma and in other 47 cases (36.4%) the picture was of chronic nonspecific inflammation with oedema. There were recurrences in 18 cases within one year of surgery. Operating measures did not prevent recurrences of vocal cord polyps. Recurrences were significantly less in the patients who stopped smoking and misusing or abusing their voices after surgery. Voice therapy and cessation of smoking in the postoperative period played important roles in the long term results of vocal cord polyps. Better outcome and rapid improvement were observed in those patients who underwent voice therapy in follow ups.

Calcification in the carotid artery (CACs) can be visible in the panoramic radiographs (PRs) near the region of the cervical vertebrae C3-C4, posterior to angle of mandible. The aim of this study was to evaluate the incidence of CACs on PRs and their linkage with hypertension, age, gender and smoking habits. PRs of 2000 patients were evaluated. The age group was chosen between 20 to70 year old people and their PRs had been taken for different clinical reasons. Information about smoking habits, hypertension and other vascular events was obtained from OPD case papers. The observers analyzed the presence of radiopaque mass in the region of posterior to angle of mandible bilaterally on PRs. The results showed a 0.6 % incidence of CACs on 2000 PRs. In our study no significant relationship was found between smokers and incidence of carotid artery calcification .In our study significant statistical correlation found between CVD and PAD and associated risk factor with CAC on panoramic radiographs.