Abstract: The function of the immune system is to protect our system from pathogens entering our body and react immunologically to cells from a genetically different person. At the same time, the immune cells maintain tolerance to our own body cells and do not reject them. This is called as self-tolerance. However, in case of autoimmune diseases and cancer, the immune system identifies our cells as foreign and generates immune reactions resulting in severe damage to the affected organ. However, on the other hand, the cancer cells are eliminated or rejected by our immune system in the early stages but support their growth at later stage. These immune reactions controlling the self-tolerance are mediated by T regulatory cells which maintain immune homeostasis under healthy condition by keeping the effector CD4+ and CD8+ T cells under regulated state. Upon loss of immune balance T regulatory cells cannot suppress the effector T cells’ activity resulting in autoimmune or autoinflammatory reactions. This review will discuss the various subtypes of T regulatory cells and their role in autoimmune diseases and cancer.

In the light on the new recent mobility - driven by ongoing and forced migration, resulting from political instability, and economic and social problems, many social efforts have been made in order to integrate these new arrivals and therefore ensure a social cohesion. Educationally, many conferences and seminars were held in order to help teachers promote a good learning atmosphere among the new arrival of learners who bring multiple languages and mobile experiences into the classroom. As far as language teaching is concerned, language teachers have been given a noble and a social, but huge, responsibility to help solving social problems. However, the question that may impose itself today is that do foreign language teachers take sufficient training programmes to meet the new needs and fulfill such roles? What teaching training programmes are being undertaken by foreign language teachers? It is argued that teachers’ roles have always been didactical – instructor, facilitator, integrator, designer, etc. However, based on the new responsibilities assigned to language teachers, their teaching training programmes should be reconsidered. Our main goal in this work is to stress the need for practical teaching training that suits the multilingual classrooms, in which the foreign language teacher does not act only as an instructor, but also as a social assistant whose responsibility is to help solving the social problems.

The purpose of this paper is to examine and review the relationships among entrepreneurial marketing, innovation, and business performance. A conceptual model of the entrepreneurial and relationship marketing created increasing innovations, and the impact on business performance. Academic implications of this paper in exploring the concept of entrepreneurial and relationship marketing increasing innovation and their impact on business performance.

Introduction: Sudden sensorineural hearing loss (SSNHL) is an audiologic emergency with an annual incidence of 5-20 per 100000. SSNHL is idiopathic most of the times however about 10-15% of cases are due to identifiable causes like Meniere's disease, trauma, autoimmune disease, infectious causes etc. Objective: To study the effect of early versus delayed treatment of Sudden Sensorineural Hearing Loss (SSNHL) in hearing outcome. Methods: A retrospective study of patients with SSNHL was done from June 2016 to study the effect of early versus late treatment in hearing outcome in July 2017. Patients receiving treatment within 3 days of onset of symptoms were placed in early treatment group (ET) and those receiving treatment after 3 but within 7 days were placed in late treatment group (LT). Hearing outcome was assessed using pure tone average (PTA) and was carried out at presentation and then at 3,7,14 and 30 days after treatment. A mixed between and within subject design ANOVA test was used to analyze the results using SPSS 20.0. Results: There were 46 patients in ET group and 39 patients in LT group. Mean age of the study population was 36.37 years (SD-7.868). The M: F ratio was 0.39:1. There was a significant interaction between time and treatment group, Wilk's Lambda= 0.382, F (1.52, 79.196) 19.83, p <0.001, partial eta squared =0.541. There was a substantial main effect of time, F (1.52, 79.196) = 180.36, p <0.001, partial eta squared 0.776 suggesting significant improvement of hearing levels with time. The main effect comparing early and late treatment groups was also significant, F (1,52) = 5.799, p=0.02, partial eta squared = 0.100 suggesting significant difference in hearing levels in between the two treatment groups. Conclusion: Onset of treatment after the initial symptom significantly affects the outcome of hearing improvement in SSNHL. There are higher chances of improving if treatment is started within 3 days of onset of symptoms.

The aim of this study is to show a brief analysis on credit sales for future services to protect the financial stability of businesses that offer them. An introductory review on the existing demand of future services is done, some theoretical basis on the concepts of savings funds, investment funds and future services are analyzed in order to understand their differences. Finally, a formula to estimate costs for future services is proposed in order to obtain the approximate costs of the services they are selling today to the moment when they are required in a future date and to make this profitable by using a financial scheme based on ordinary annuities.

Objectives: To thoroughly evaluate the causes, associated risk factors, and management of anxiety and depression (AD) among young adults by synthesizing current literature. Methods: A thorough search of pertinent databases was done in order to find studies that satisfied the requirements for inclusion. A thorough search of PubMed, Web of Science, SCOPUS, and Science Direct was conducted to find pertinent literature. Results: Nine studies, including a total of 13628 participants diagnosed with anxiety or depression or both, and 4972 (63.2) of them were males, were included in our data. Earlier use of cannabis, poverty, romantic love, and internet addiction were found to be associated with AD in young adults. Brief psychodynamic therapy seems to be a promising strategy for young adults experiencing mild to moderate AD. Cognitive behavioral therapy (CBT) classes, even for short durations, are also beneficial in treating student patients' AD. Referring patients with more severe symptoms to a psychologist skilled in CBT may be beneficial. Conclusion: The development of AD among young adults is multifactorial. Psychodynamic therapy was recommended for mild to moderate AD, while CBT was proposed for young adults with severe forms. Longitudinal, prospective, and randomized trials are needed to study the interventions that may improve AD among young adults as well as the possible causes.

The improvement of public service delivery involves capacity building in public servants. Training programmes are one of the most popular capacity building approaches. The purpose of this study was to investigate the influence of these human capacity development programmes on public service delivery. The objectives of the study were to find out how training influence performance improvement in the public service. The research used descriptive research design with stratified random sampling to select the samples. The samples were picked through simple random sampling thus enabling all members of the target population to be represented. The target population comprised of 300 active members of the African Association for Public Administration and Management (AAPAM) and 20% of the target population formed the sample size. Questionnaires were used for data collection. The study found that training has a moderate positive influence on service delivery and this is attributed to effective training content and training methods. The study recommends adoption of proactive human capacity development strategies and incorporation of technology to enhance their positive influence on service delivery and mitigate on the negative influence to ensure efficient services are offered to the citizens.

Introduction: Oligohydramnios, a common amniotic fluid disorder, is marked by reduced fluid volume for gestational age. This study aims to assess its risk factors and clinical outcomes to enhance maternal and neonatal care in a tertiary hospital in Bangladesh. Aim of the study: The aim of the study was to evaluate the frequency of risk factors and clinical outcomes in pregnancies with oligohydramnios at a tertiary care hospital in Bangladesh. Methods: This prospective observational study was conducted in the Department of Obstetrics and Gynecology at BSMMU, Dhaka, from June 1, 2016, to May 31, 2017, enrolling 200 pregnant women with oligohydramnios. Data on antenatal and postnatal histories, clinical examinations, and investigations were collected. SPSS version 22.0 was used for descriptive analysis of demographics, maternal and neonatal outcomes, and risk factors. Result: In a study of 200 pregnant women with oligohydramnios, the mean age was 23.9 years, with 65.5% aged 20-25. The most common risk factor was idiopathic oligohydramnios at 24.0%. Maternal outcomes revealed 58.0% had normal vaginal deliveries and 42.0% cesarean sections, primarily due to fetal distress. Among neonates, 54.5% were appropriate for gestational age, 70.9% had low birth weight, and 65.4% had APGAR scores below 7 at 1 minute. Conclusion: Oligohydramnios is a prevalent complication in pregnancies that requires vigilant monitoring and timely interventions to improve maternal and neonatal outcomes, given its association with low birth weight and increased cesarean delivery rates.

This paper aims to analyze the sonnet 138 written by William Shakespeare from a stylistic point of view. The division of Shakespeare‟s sonnets is shown. A short introduction to both style and stylistics in literature are written. For further facilitation, a short introduction to Shakespeare, the sonnet 138 and its themes are given. The stylistic analysis of the sonnet is shown from four sides. Graphological, grammatical, phonological and lexical analyses are shown. This paper will help to understand the structure and style of Shakespeare‟s sonnet number 138. Moreover, the themes and ideals of Shakespeare will also be understood.

Optimizing nurse assignments is crucial for maintaining quality care and improving patient outcomes, as nurse staffing represents 40% of hospital costs. A change from assigning nurses at random to using scientific criteria has affected operations, funding, worker happiness, and patient safety. Patient diagnoses, continuity of care, and nurse-to-patient ratios are important factors to take into account. Improving nursing productivity and lowering turnover now depend on skill mapping, which assesses nurses' competencies according to hospital requirements. Improving nurse satisfaction and the caliber of patient care requires effective staffing strategies that are adapted to the needs and acuity of the patients. This review of the literature looks at how skill mapping and acuity tools can be combined to improve patient outcomes, maximize resource usage, and improve nursing activities. It demonstrates how useful Perroca's instrument is in guiding care planning and management decisions.

This research aims to determine the impact of visionary leadership, learning organization, and innovative behavior on the performance of Functional Officers of Customs and Excise Inspectors at Tanjung Priok Customs and Excise Main Service Office. The research was conducted at Tanjung Priok Customs and Excise Service Office using the number of samples of 78 Functional Officers of Customs and Excise Inspectors. The sample was selected using simple random sampling technique. Data collection was done by using questionnaire and data analysis using path analysis. The results showed that 1) visionary leadership, learning organization and innovative behavior have a direct and positive impact on performance, 2) visionary leadership, and learning organization have a direct and positive impact on innovative behavior and 3) visionary leadership have a direct and positive impact on learning organization. The conclusion of this research is to improve the performance of Functional Officer of Customs and Excise Inspectors at Tanjung Priok Customs and Excise Main Service Office, it is necessary to increase the aspect of visionary leadership from Head of Main Service Office, learning organization at Main Service Office and innovative behavior at Functional Officers of Customs and Excise Inspectors.

Introduction: PCOS is a common condition that increases the risk of gestational diabetes mellitus (GDM) due to insulin resistance. The purpose of this study is to evaluate the relationship between PCOS and Gestational Diabetes Mellitus. Aim of the study: The aim of the study was to evaluate the relationship between Polycystic Ovary Syndrome (PCOS) and the development of Gestational Diabetes Mellitus (GDM) in pregnancy. Methods: This comparative cross-sectional study was conducted in the Department of Obstetrics and Gynecology at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, from June 2015 to May 2016. It involved 100 pregnant women, 50 with PCOS and 50 without, who underwent fasting glucose, 2-hour OGTT, and HOMA-IR tests. Data on gestational diabetes and pregnancy complications were collected and analyzed using SPSS version 22.0. Result: The study revealed that the PCOS group was older (29.4 ± 4.1 years) compared to the Non-PCOS group (27.2 ± 5.0 years), with a higher incidence of GDM (26.00% vs. 10.00%). Pregnancy complications like preterm birth were more common in the Non-PCOS group (24.00%), while GDM occurred more often in the PCOS group (26.00%). Additionally, the PCOS group had higher fasting and 2-hour OGTT glucose levels and showed greater insulin resistance (3.5 ± 1.2 vs. 2.3 ± 0.9). Conclusion: This study confirms that women with Polycystic Ovary Syndrome (PCOS) have an increased risk of Gestational Diabetes Mellitus (GDM) and exhibit impaired glucose metabolism, underscoring the importance of close monitoring during pregnancy.

The drinking water (potable water) is that water which is safe for human consumption .The analysis of drinking water determines the identification of bacteria and the effect of some other metals on them. The work was carried out in Sri Ganganagar zone. The samples were collected from 15 to 35 km. area of Sri Ganganagar,Rajasthan. The work was completed in the department of microbiology of Tantia University, Sri Ganganagar. Isolation and cultivation of Escherichia coli (E.coli) and Staphylococcus aureus(S.aureus) was done by using varies isolation techniques like serial dilution method, spreading etc. and applied different media like nutrient agar, Eosin Methylene Blue , MacConkey agar and special media and various biochemical reactions. Therefore, S.aureus and E.coli strains were selected for this antibacterial study. Both gram positive and gram negative microorganisms were used for the test and Al, Zn, Mn, and Fe metals were selected for study of antimicrobial effects. Prepared the cultured plate of E.coli and S.aureus and add the metals in the middle of the Petri plate and after overnight incubation obsevered the effect of metals. The result shown that Mn has no antimicrobial effect but Al, Fe and Zn has antimicrobial properties. Fe shown strong effect as compared to Al and Zn. The object of this study to investigate the antimicrobial effect of metals such as Mn, Al, Zn and Fe on drinking water bacteria such as E.coli and S.aureus. Antimicrobial properties of metals will be use for purification of drinking water and remove the bacterial contamination from the drinking water with the help of metals.

Background: Missing teeth can significantly affect the intercuspal position (ICP) and contribute to temporomandibular joint (TMJ) disorders, which in turn impact the overall masticatory function and oral health. This study investigates the effect of missing teeth on ICP and TMJ symptoms and evaluates the outcomes of prosthodontic rehabilitation. Methods: A total of 120 participants with varying patterns of tooth loss were enrolled in the study, which took place from January to December 2016 in the Department of Prosthodontics at Bangabandhu Sheikh Mujib Medical University and Beau-Dent, Dhaka, Bangladesh. Results: The study included 69 males (57.5%) and 51 females (42.5%) with a mean age range of 36–50 years (40.8%). The results showed that the shift in ICP was most prominent in participants with posterior tooth loss (80%), followed by mixed tooth loss (85.7%) and anterior tooth loss (71.4%). TMJ symptoms were common, with clicking reported by 41.7% of participants, pain by 29.2%, and restricted movement by 16.7%. After prosthodontic rehabilitation, significant improvements were observed in several measures: occlusal contacts increased from 4.5 ± 1.8 to 7.8 ± 2.1 (p < 0.001), bite force improved from 150 ± 30 N to 320 ± 45 N (p < 0.001), and TMJ symptom severity decreased from 3.8 ± 1.2 to 1.2 ± 0.8 (p < 0.001). Conclusion: Missing teeth have a significant impact on intercuspal position and contribute to TMJ symptoms. Prosthodontic rehabilitation effectively restores ICP, improves bite force, and reduces TMJ symptoms.

Many studies have proven an inverse correlation between HDL rate and the risk of evolving toward an ischemic heart disease. This study’s goal is to spot patients with significantly low HDL to attempt finding new eventual elements characterizing this kind of situation, or at least, affirm the stability of those already acquired. It is a transversal study conducted in the biochemistry and toxicology department at the moulay Ismail Military hospital in Meknes over a one year period (June 2014 – June 2015). The retained patients were ones with an HDL lower than 0.20 g/l. Their medical files were taken from the appropriate services to collect on a record operating the interesting data for the study. 50 patients were taken in. Their average age was 51, 7 year old and the sex ration M/W was 1.4. The infections disease followed half of the cases, malaria being the majority with 32% of cases infections. 28% of cases were patients with cancer, 10% patients with diabetes. 6% were psychiatric diseases and 6% were malnutrition associated with inflammation cases. Hypertriglyceridemia was associated to hypoHDLemia in 46% of cases. HypoHDLemia can be transitory with acute infections and disappear along with it. Nevertheless, it can persist with chronical infections such as viral hepatitis, cancer, diabetes and psychiatric diseases, hence the value of a regular control of the lipid profile.