A 59-year-old male with primary sclerosing cholangitis (PSC) presenting with a suspected dominant biliary stricture suspicious for cholangiocarcinoma developed acute cholecystitis following cholangioscopy. This is the first case report of this rare complication that may have been related to the irrigation occurring during the procedure. Early recognition of this rare complication will likely lead to timely antibiotic therapy.

New challenges about how to measure the performance of organizations have arisen since big data can be found everywhere. In order to make proper decisions, management needs to have strong insight into what is important to the firm and how to improve it. This study looks into logistics companies that rely heavily upon labor as the examples. While transportation and distribution are very important processes for logistics companies to meet customers‟ requirements, the process of creating appropriate measures is difficult due to the complexity of these activities. The aim of this research is to evaluate the relationship among these key performance indicators and find out the possible direction and coverage of improvement for such companies using hybrid DANP1 cause-effect and Influential Network Relation Map models. We collected data through expert questionnaires with questions based on discussions with experts (including managers and scholars). The research results help support managers‟ decision making for improvements in their firm and also can be applied in employee reward systems.

Severe postburn contracture deformity of both knee and ankle joint causes severe functional limitations. The mainstay of treatment is early surgical excision of contracture tissue and resurfacing with STSG, local flaps and free flaps. All patients admitted with severe postburn contracture of knee and ankle joint between January 2016 to April 2018. All underwent staged management with excision of contracture tissue followed by continuous skin or skeletal traction. And after correction of residual joint contracture the defect is resurfaced with STSG. In all patient’s correction of flexion deformity was achieved. Graft failure was present in 5 patients, in which 2 required re-grafting. Staged treatment with excision followed by continuous traction and then resurfacing with STSG. Customized post-operative splintage results in full correction with adequate coverage of knee and ankle joint contracture

Eyes are generally the first features of the face to be noticed, playing a significant role in our daily lives. The most grievous yet, unfortunately, the most commonly occurring loss out of all the sensory organs is that of an eye. Such an adversity may have a prodigious emotional and psychological impact on the patient with loss of function. Artificial replacement of the lost eye is done with an ocular prosthesis. The prosthesis will improve patient’s esthetics, restore and maintain health of these structures, and thereby provide physical and mental wellbeing. Accurate impression to duplicate the contours of the defect site is required for the fabrication of the custom made prosthesis. In the following case report, a custom made scleral shell prosthesis was fabricated for the patient.

‘Poison’– The term first appeared in English Literature around the year 1230. It refers to a substance with an inherent property of being harmful to life or health. The earliest used poison, used in wars and official executions, included plant extracts, animal venoms and minerals. The aforementioned poisons are still used in the present day though they are not amongst the more prevalent ones, the trends having changed over the last millennium. Aluminium Phosphide poisoning occurs most commonly through ingestion and is seen more frequently in young males in their third decade. Fresh AlP is associated with higher and quicker fatality with respect to stored poison, less survival, more mortality.

Several denture based materials have been used with a wide range of applications. Several techniques have been used in recent time to improve its properties for better durability, strength and working. To compare Impact Strength, Compressive Strength, Tensile Strength, Hardness and Dimensional accuracy of autopolymerized, postpolymerized microwave exposed autopolymerized and heat-cured denture base resins. Specimens were prepared by different modes of polymerization using autopolymerization technique, microwave post-polymerization treatment of autopolymerized acrylic resin and conventional water bath technique. The specimens were then subjected to various tests to evaluate strength (Impact, compressive, Tensile) and Hardness. There is statistically significant difference was found between mean impact strength and compressive strength of autopolymerized, postpolymerized microwave exposed autopolymerized and heat-cured denture base resin. There is no statistically significant difference between mean tensile strength of autopolymerized acrylic resin and postpolymerized microwave exposed autopolymerized acrylic resin (p=1.000) but a statistically significant difference was found between mean tensile strength of autopolymerized acrylic resin and heat-cured denture base resins (p=0.001). There was a statistically significant difference between mean Rockwell Hardness Number of autopolymerized acrylic resin and postpolymerized microwave exposed autopolymerized acrylic resin (p=0.005). A statistically significant difference was also found between mean Rockwell Hardness Number of postpolymerized microwave exposed autopolymerized acrylic resin and heat-cured denture base resins (p=0.001). Similarly, there was statistically significant difference was found between mean Rockwell Hardness Number of autopolymerized acrylic resin and heat-cured denture base resins (p=0.03). Comparison of mean linear dimensional change between autopolymerized and postpolymerized microwave exposed autopolymerized denture base resins showed no statistically significant difference in the mean dimensional change between the autopolymerized and postpolymerized microwave exposed autopolymerized denture base resins (p=0.051). Heat-cured acrylic resin exhibited the maximum values for Impact strength, Compressive Strength, Tensile Strength, Hardness and Dimensional Accuracy and Impact Strength of autopolymerized acylic resin improved after microwave postpolymerization treatment. Whereas, Hardness is decreased and Dimensional accuracy remained unaffected after the microwave postpolymerization treatment of autopolymerized acrylic resin.

The relevance of the International economic institutions and Economic Development Agreements (EDAs) in the world today cannot be overemphasized. Several scholars have opined that they engender developments, particularly, in the country or countries of interest, and/or where the EDAs have binding force. In the same vein, the concept and principles of sustainable development balances the need for economic advancement with the need to preserve global environment to the benefit of the present and future generation. This paper examined the role of international economic institutions and economic development agreements in pursuing sustainable development. From the examination, it was observed that EDAs executed between countries now consider environmental factors and other aspects of sustainable development as veritable elements. And that Sustainable development has reshaped the interpretation of key provisions within the WTO’s agreements.

Odontomas are mixed benign hamartomaous malformation of odontogenic origin. Mainly two type complex and compound Odontomas, complex type more often seen in premolar and molar region of mandible, compound type more often seen in anterior maxilla. They commonly occur in permanent teeth. They are generally assymptamatic, detected on routine radiographic examinations or radiographs are taken to determine the reason for failure of a tooth to erupt. Odontogenic tumor treated by surgical enuclieation of lesion. Here we report a case of complex Odentomas in an 11 year old girl that cause distal displacement of maxillary lateral incisors, which is rare occurrence.

Prostate cancer became a major public health problem on the threshold of the third millennium. The trilogy rectal touch, PSA-iso forms and biopsy is the pillar of the diagnostic approach and a pragmatic reflection. This is a retrospective study including the analysis of the medical records of 1053 patients admitted between 2000 and 2015. The inclusion criterion is a rate of PSA-T between 4 and 10 ng / ml which corresponds to 783 patients (74.3%) constituting two groups, one of 253 (prostate cancer), the other of 530 (adenomas = control group). The aim of our study is to evaluate the interest of the PSAL / T ratio in the North African population. The median age of patients was 63 years, 70.3% were symptomatic. The median PSA-T is 6.9ng / ml with a PSAL / T ratio ranging from 7% to 32% with an average of 19%. The mean prostatic volume is 57 cm3. 32, 3% with prostate cancer. The sensitivity and specificity of the PSA L / T ratio according to the cut-offs were studied at the time of diagnosis of prostate cancer and the value of 17% was retained with the best compromise between specificity (68%) and sensitivity (57%). A PSAL / T ratio <15% is the best detection rate for prostate cancer (52%). The contribution of the PSA-L / PSA-T report is indisputable since the first contact with the patient in consultation; the results in the Maghreb are comparable to those found in the literature. This iso PSA form reduces many unnecessary biopsies when it is greater than 25%.

Pemphigus is a group of mucocutaneous blistering disease which can be seen involving only the oral cavity also. The cutaneous lesions are preceded by oral lesions in many cases reported in the literature. This condition is very painful and it affects the quality of life of the patient. Early diagnosis of the disease will improve its prognosis and quality of life of patients as severe conditions are life threatening. Here were are reporting a similar case of Pemphigus Vulgaris.

A new stability indicating RP-HPLC method was developed and validated for the simultaneous estimation of Sofosbuvir and Daclatasvir in pharmaceutical dosage form and bulk drug. The optimized conditions for the simultaneous estimation of drug includes Discovery C18 (150mm x 4.6 mm, 5m) column, 0.01N potassium dihydrogen phosphate and Acetonitrile (50:50%v/v) as mobile phase run on isocratic mode at a flow rate 1.0ml/min. The column is maintained at 30ºC temperature and the drugs are detected at a wavelength of 254nm. The retention time for Sofosbuvir and for Daclatasvir were found to be 2.47 min and 3.31 min respectively. The %RSD for Sofosbuvir and Daclatasvir were found 0.8 and 0.5 respectively. The % Recovery for Sofosbuvir was found to be 99.90% - 100.03% and % recovery for Daclatasvir was found to be 99.90% - 99.93%. A linear response was found in the concentration range of 100µg/ml – 600µg/ml for Sofosbuvir and 15µg/ml – 90µg/ml for Daclatasvir, with correlation coefficient of 0.999 for both the drugs. The method was found to specific, accurate, precise, robust, rugged and stable in solution for 24 hours. The forced degradation studies indicated that the drugs are stable in various stress conditions as the net degradation was found to be within the limits. The developed method can be used for the quality control for simultaneous estimation of Sofosbuvir and Daclatasvir in pharmaceutical dosage form.

PT Nexus Fashion & Sports is a manufacturing industry that produces work gloves and sports. The company's current production system has not been able to run effectively and in balance because production demand and production planning always change. Applying the right production system can provide the right production process. The Toyota Production System (TPS) can help companies cope with demand fluctuations and control production planning in a controlled manner. The basis for the implementation of TPS is the principle of heijunka, namely the fundamental removal of mura, muri, and muda. This study aims to measure the effectiveness of the production process and design the TPS based on the principle of heijunka to improve the productivity of human labor. Analysis of production process effectiveness using manufacturing cycle effectiveness (MCE) method was 67% and improvement proposal was 69%. Production rate balancing (mura) on production scheduling of TPS design based on heijunka principle using mixed model scheduling method produces daily flat based production. Alignment of workload (muri) using work load analysis method in March and April 2017 TPS design based on the principle of heijunka there were advantages of 1 person and 4 people. The average human work productivity of TPS design based on heijunka principle increased by 1.10%.

Courts are the cornerstone of an ordered society. Legislature legislates or enacts law and statutes are the edict of the legislature. Courts implement those edicts through interpretation. Legislature lays down the general principles. Judiciary applies those principles in concrete cases. From the earliest Vedic ages, India has had a recorded legal history. In fact, a civil legal system might well have been in existence in the Bronze Age and in the Indus Valley civilization. India was always governed by laws as laid down in the Arthashastra way back in 400 BC and then later in 100 AD in the Manusmriti. The Vedas, Upanishads and other religious books of the Hindus, Jains and Buddhists put laws in place in ancient India, so the Indians of these times were already exposed to the idea of living under the law. The first major case of judicial activism through social action litigation was the Bihar under trials case. In 1980 in came in the form of a writ petition under Article 21 by some professions of law revealing the barbaric conditions of detention in the Agra protective Home, followed by a case against Delhi women's Home field by a Delhi law faculty student and a social worker. Judicial activism is not an aberration. It is an essential aspect of the dynamics of a constitutional court. It is a counter-majoritarian check on democracy. Judicial activism, however, does not mean governance by the judiciary. Judicial activism must also function within the limits of the judicial process. Within those limits, it performs the function of stigmatizing, as well as legitimizing, the actions of the other bodies of government – more often legitimizing than stigmatizing.

Corporate governance is mechanism use to improve firm performance and value because it reduces the level of expropriation of the company’s assets by the management and it also improves the level of expected cash flows that can be distributed to shareholders in form of dividends. The study examines how corporate governance has affected corporate performance under pre and post adoption of IFRS. The findings show that corporate governance is more effective in explaining and predicting corporate performance of listed deposit money banks in Nigeria after the adoption of IFRS better than before the adoption. In view of this, the study recommends that there is need to encourage application of IFRS principles by banks and other institutions to enhance corporate performance of deposit money banks in Nigeria.

This study aims to examine, analyze and explain the impacts of compensation, career development and employee engagement to employee’s performance partially and simultaneously (Case Study at PT Bank XYZ). The research design used is quantitative descriptive research causality involving 30 respondents. Sources of data are from primary and secondary data, primary data obtained from questionnaires distribution and secondary data obtained from journals and books. Data analysis used model test using smart application PLS 3 that consists of test outer model and inner model. The results showed that compensation, career development and employee engagement partially have a positive impact on employee performance, while they have a positive and significant impact on employee performance simultaneously. The independent variable has the greatest impact is the employee engagement.