It happens many times that the dental surgeon faces a tricky situation when fracture of the root tip occurs during tooth extraction. It is frequently a time consuming and a stressful situation for the patient as well as to the surgeon when attempting removal of these root apices . Though many techniques have been described in the literature, they have some disadvantages. The present article describes a case series of two reports in which we have done atraumatic removal of the broken root tips with the help of endodontic files.

This study was geared towards appraising the curriculum status of integrated Social Studies in Kenyan primary schools in the wake of a lot of fluid content which keeps on changing day in day out. To deal with the quick changes there’s need to use Curriculum foundations sieves to allow only concrete content in the integrated Social Studies Curriculum. 250 teachers were sampled using stratified simple random sampling for teachers and purposive sampling for Tutors from the two Primary School Teacher Training College in Nakuru Sub County, the chair-persons of the Head teachers of the five zones of Nakuru Sub-County and the Quality Assurance and Standards Officers. Research Instruments were questionnaire and semi-structured interview guide. This research study adopted a mixed research methods approach. Both descriptive and inferential statistics were applied in the analysis of data. Findings show that the content of integrated Social Studies (SST) is beneficial to learners, it contributes to the attainment of the national goals of education, it has been changing very quickly within short span of time hence need to elongate time before next revision is done, the Social Studies teachers need to be taken for refresher courses to improve their teaching skills, there’s relationship among topics taught from one class and the next and that integrated Social Studies curriculum has integrated emerging issues. The recommendation is that the government through Kenya Institute of Curriculum Development (KICD) should take time before reviewing Social Studies curriculum.

Medullary aplasia (MA) is a rare and severe affection. It is much rarer in children. The etiologies are multiple: constitutional, acquired, and idiopathic. In order to evaluate the epidemiological, clinical and biological aspects of bone marrow aplasia in a pediatric population, we carried out a retrospective study of 9 cases collected in the hematology department in collaboration with the department of anatomy pathology of the Hassan II CHU in Fez over a four-year period from January 2013 to December 2016. Age ranged between 1 and 14 years, with a sex ratio of 3.5. The anemic, hemorrhagic and infectious syndrome was noted respectively in: 9, 7, and 6 cases. The hemoglobin varied between 3.3 and 7.3 g/dl with an average of 5 g/dl, anemia is normochrome normocytic argenerative in all our patients. Neutropenia was found in 100% of patients, and all patients had thrombocytopenia with platelet counts ranging from 500 to 105000/mm3. The BOM-coupled myelogram was performed in all patients, confirming the diagnosis of AM. For the etiologies, Fanconi Anemia was evoked in 4 cases and idiopathic in 5 patients.

Primary plasma cell leukemia: a rare type of leukemia and plasma cell proliferation Plasma cell leukemia is defined by the presence of more than 20% plasma cells in the peripheral blood or a number of circulating plasma cells greater than 2G/L. The primary form: observed may be de novo, and may reveal a multiple myeloma until then unknown. This has similarities with multiple myeloma and has some special particularities that authors will expose in the light of a case diagnosed in the laboratory hematology Hassan II university Hospital of Fez.

Macrophage activation syndrome is a rare but a potentially fatal disease. This pathology is defined not only by clinical criteria (fever, splenomegaly), but also by biological criteria (bi or pancytopenia, hypofibrinogenemia, hypertriglyceridemia, hyperferritinemia) and cyto histological ones (hemophagocytosis in the bone marrow, in the spleen or in the peripheral lymph nodes). It may be primary or more often reactive to an infectious or a malignant pathology, an immune deficiency, or an autoimmune systemic disease. Its occurrence imposes a quite exhaustive etiological assessment, as the associated diseases are multiple. We report in this work the case of a patient in whom a macrophage activation syndrome secondary to a bacteraemia was diagnosed in the laboratory of Hematology of the Hassan II University Hospital -Fez, and whose evolution was marked by a good response to antibiotic therapy with a regression of clinical symptoms and an improvement of the biological parameters. However, the prognosis for macrophage activation syndrome remains severe with about 50% mortality in the literature. It is therefore considered as a serious condition, with a severe prognosis and a treatment that is still poorly codified.

Streptococcus constellatus is a germ that belongs to the Streptococcus milleri group, it has a particular tropism for the digestive tract and the hepatobiliary region. It is found in deep abscesses in immunocompromised patients. 70-year-old patient admitted to the emergency room for a pain in the right iliac fossa. The abdominal scan showed a retro cecal collection probably related to an appendicular abscess. The cytobacteriological study of abscess sampling in peroperatively demonstrated the presence of Streptococcus constellatus associated with Escherichia coli. The identification of a streptococcus of the milleri group is difficult by ordinary methods and must make search for an abscess.

The purpose of the study was to determine anemia prevalence on less than ten years old children patients’ attending Rongo sub-county hospital, Kenya. The country has experienced rapid economic growth over the last few decades, significant health and nutritional problems remain. Unfortunately, because little work has been done to track basic diseases, such as iron-deficiency anemia, the exact problem of these health problems still remain unknown. The study comprise 250 parents, 7 medical laboratory technologists/technicians, 1 medical superintendent 1 hospital administrator.The study adopted hospital based cross sectional survey design.Since the hospital is one, there is one medical superintended and an administrator; purposive sampling was used to select them as they were few. Due to the fact that there are 250 parents of anemic children attending the hospital 30 percent of them was considered hence 75 parents/guardians. The study used questionnaire. The actual data collection, a pilot study was conducted in the same county among the parents of less than ten years old attending Minyenya health centre which was not included in the final study population. From this health centre where 10 parents were be randomly selected for the pilot study, 3 medical laboratory technologists, and their respective hospital administrator and medical superintendent. A minimum correlation coefficient of 0 .65 is recommended and considered reliable.

The aim of this study was to estimate the prevalence and risk factors for different neurological disorders. We also aimed to explore the effect of different socio-demographic variables in neurological disorders. Methods: A prospective cross-sectional study was carried out at Neurology Outpatient Clinic of United Hospital Ltd., Bangladesh, from December 2015 to March 2016 to explore the experiences of patients with neurological disorders. A separate questionnaire was used to collate the information. All registered patients medical records were reviewed. Microsoft Office Excel 2007 software package was used for statistical analysis. Data of 438 patients were collected and analyzed of which 239 (54.57 %) were females and 199 (45.43 %) were males. This study showed a high prevalence of epilepsy, stroke and migraine and an overall low prevalence of Parkinsonism, Alzheimer’s and dementia. The values were 121, 97, 52, 43, 23 and 102 for epilepsy, stroke, Alzheimer’s, Dementia, Parkinson’s and Migraine accordingly. Most of the patients (79.95%) were unmarried in our observational study. Only 20.06% were married. 41.03% and 26.18% patients were alcoholic and smoker respectively. Highest percentage of the patients (27.27 %) belonged to the age group 61 - 70 years, 21.23% to the age group 41 - 50 years and 17.05 % to the age group 51 – 60 years. Moreover, 42.98% of the patients were from community colony. The findings from the present study supported some previ¬ous research studies showing that women are more adversely affected by different neurological disorders than men. Therefore, more epidemiological studies need to be conducted to look into the changing pattern of neurological disorders using a uniform methodology.

The regional human capital trend is scrutinized in this article relying on indicators of the cultural and intellectual potential based on the statistical data of Primorsky krai region. Additionally, the effect of migration processes on the labor potential is deliberated, just as the budgetary and fiscal stimulation of human capital inflow is considered at an angle of the regional labor potential increase.

This study looked at if there was any significant difference between teachers‟ and students‟ perceptions on the ban of corporal punishment in school in Kosirai Division, of Nandi County public secondary schools by gender, age, highest level of education and experience in school. Descriptive-comparative survey research design was used. Fifty eight (58) teachers participated. Questionnaires were used to collect data from the respondents. Validity was determined by the use of expert opinion in matters education in the department of educational administration, curriculum and teaching of University of Eastern Africa, Baraton. The reliability of the questionnaire was done through a pilot study done in two (2) public secondary schools in Eldoret Municipality. Thirty (30) teachers participated in the pilot study. Cronbach‟s alpha of 0.6 was set as the cut-off point. The Cronbach‟s alpha for teachers‟ questionnaire was .654 T-test was used to determine the difference between the mean ratings of boys and girls, female and male teachers, age, teaching experience and level of education of teachers. The findings indicated that there was no significant difference between teachers‟ perception on the ban of corporal punishment in schools in Kosirai Division secondary schools when categorized by gender, age, education and experience. This study recommends that alternative ways of discipline be sourced and applied to avoid physical pain to students.

Staphylococcus aureus stays a standout amongst the most much of the time segregated pathogens in both group and hospital practices. The organism form has been observed to be the most widely recognized bacterial agent recuperated from blood circulation system diseases, skin and soft tissue contaminations, pneumonia and healing facility procured post-agent wound diseases. Changes in the example of antimicrobial helplessness of S. aureus and different living beings have been accounted for around the world, particularly in developing countries, making antimicrobial agents progressively less viable in treating bacterial infections. Most strains of the Gram-positive bacterium Staphylococcus aureus are avirulent, anti-infection soft commensals; in any case, in the course of recent decades there have developed various pandemic, harmful, anti-microbial safe strains including methicillin-resistant (MRSA) and vancomycin-resistant (VRSA) strains. This paper presents the review analysis of various studies based on antimicrobial patterns detection of Staphylococcus aureus.

Thromboprophylaxis methods mainly include pharmacological and mechanical options, such as intermittent pneumatic compression devices (IPCDs). In a specific population (post-operative and post-traumatic patients) the risk of VTE is combined with increased risk of bleeding complication which is the side effect of the pharmacological prophylaxis. The aim of this integrative review is to assess the effectiveness and safety of IPCDs as an alternative choice to pharmacological prophylaxis in post-surgery and post-trauma patients. The electronic databases CINAHL, MEDLINE EMBASE, and Cochrane libraries were systematically searched for primary studies. We included studies that had evaluated the effectiveness and safety of the sole use of IPCD against the sole use of pharmacological prophylaxis in post-surgical and post-trauma patients. A total of 13 eligible articles were identified. Post-trauma patients were enrolled only in two studies and the remaining 11 studies were conducted on post-surgery patients. The findings suggest that IPCDs, compared with pharmacological prophylaxis, are equally effective in reducing DVT, PE and mortality rate and offered a reduced risk of bleeding. There were no consistent relations between the types of IPCDs and the clinical outcomes. This review demonstrates that there is lack of strong evidence informing the comparative effectiveness of IPCDs against pharmacological prophylaxis. Additionally, there is very limited evidence that can inform which type of IPCD is more appropriate as a thromboprophylaxis tool. Thus, until further robust research is conducted, it is difficult to conclude that IPCDs can replace pharmacological prophylaxis for post-surgery and post-trauma patients

Statistics on enrolment indicates that, Kenya is experiencing class repetition in primary school education despite the gains earlier made associated with universal access to primary school education. The practice increases the possibility of the pupil to drop out of school. The purpose of this study was to investigate head teachers’ transformational leadership intervention strategies on class repetition in primary school education in Kenya. The study was guided by Self-Efficacy theory developed by Bandura Albert and pragmatism philosophy and conducted in Uasin Gishu County in Kenya. The study found out that, pupil academic performance, curriculum instruction, school culture and dynamic leadership are important intervention strategies related to head teachers’ transformational leadership that have an influence on class repetition. The study recommends a further study on a situational analysis of transformational leadership training as a new management strategy in primary schools in the 21st century in the country.

This paper presents the difference between hospital nurses’ and clinical instructors’ experienced job stress as well as their attitude towards performing their work. Results revealed that clinical instructors experience moderate stress in terms of their physical environment, workload and responsibilities, and social relationship. Despite their perception with respect to their stress level, they can still cope with their stressors as evidenced by their good work attitude. Hospital nurses, on the other hand, experience high stress level in terms of physical environment and moderate stress level in terms of their workload and responsibilities and social relationship. Clinical instructors still utilize their coping strategies in dealing with stressors as supported by their fair and good work attitude in terms of their organizational commitment and job satisfaction.

Etiological factors leading to hyperbilirubinemia vary among different geographic regions. The present study was planned to study the pattern, causes, risk factors, treatment and outcome of neonatal hyperbilirubinemia in a tertiary care setup from northern India. A retrospective cohort of jaundiced neonates seeking care for their illness at this tertiary care centre during formed the study population. All treated cases of neonatal hyperbilirubinemia were analyzed and data on gender, gestation age, mode of delivery, blood group incompatibility, sepsis, parity and birth weight were obtained. The commonest cause of neonatal hyperbilirubinemia was physiological jaundice (41.04%). Mean bilirubin values for pathological cases (18.11± 5.54 mg/dl) were higher than physiological jaundice (12.06 ± 3.59 mg/dl). Top three causes of pathological hyperbilirubinemia were ABO incompatibility (32.55%), Rh incompatibility (11.79%) and breast feeding (6.13%). Mean age of presentation with jaundice was three days. Majority (48.58%) of the cases had their total bilirubin levels equal to or below 15mg/dl. Almost all the neonates showed improvement with phototherapy and exchange transfusion. Hyperbilirubinemia is a commonly encountered problem in our NICUs. ABO and Rh incompatibility are mainly responsible for pathological jaundice. Phototherapy is found to be a safe and cost-effective way to manage neonatal jaundice.