Dengue is a vector born viral infection that belongs to family Flaviviridae. It is a single stranded RNA virus and endangers 2.5 billion people world wild. Dengue viral (DENV) infections cause a broad spectrum of illnesses from self-limited fever to severe hemorrhagic manifestations and increased vascular permeability. Cardiac manifestations of dengue are rarely associated with severe dengue fever. There are ample of dengue with myocarditis reported all over the World. But dengue with acute myocardial infarction (AMI) is rare, we reported dengue with AMI during the last outbreak and also we reported our challenges faced during the management period.

It is important for any health system to provide Nursing care and treatment with great quality and respond the client’s necessities. About Hepatitis C disease discrimination and stigmatization is very common in health care sector. In India nursing college student stated that Patients with hepatitis C often encounter incrimination and prejudice in the hospitals, by the family and common people. Because of increasing prevalence of Hepatitis C, It is very important to take appropriate action regarding HCV in Government Hospital of Jhang. The aim was to assess the exact knowledge and attitude of Nurses about care and treatment of Hepatitis C. Quantitative descriptive cross sectional study design was used and questioners on five point Likert scale ranging from strongly disagree, disagree, neutral, agree, strongly agree were distributed . Simple convenient sampling technique was used and Sample size was 222 Nurses from selected hospital. Reliability was checked on Cronbach, s alpha, it was .886 for knowledge and .738 for attitude that is reliable. Data was analyzed SPSS software 21. Most of the participant shown negative attitude regarding HCV 65% (n=146) shown sorry for HCV contracted through blood transfusion. 72% (n=160) respondent not like treating patient with HCV. 69.8% (n=155) respondent were not willing to treat HCV patient. 72.4% (n=162) not believe that their profession plays an important role in HCV treatment. 83.7% (n=186) agree that that they do, not have skills needed to effectively and safely in treating HCV patient .There was association between knowledge and attitude score. Study result shows lack of readiness about HCV patient, that is due to bias and stigmatization .It is therefore very important to improve Nurses knowledge and attitude about hepatitis C disease.

Nursing education is a program in which, through nursing training, nursing student becomes a competent nurse. Nursing training is a mixture of two learning, Theoretical learning and practical learning. Nursing Students in clinical setting learn from the behavior, knowledge, experience and skills of their clinical instructor, clinical Teaching Behavior and students learning have a significant relationship to each other. The Purpose of this study was “To assess the relationship of the teaching behaviors of nursing faculty in clinical site with students learning”. This study was carried out by using descriptive cross sectional study design an the data was collected through convenient sampling method from Sir Ganga Ram Hospital and Mayo Hospital in Lahore, Pakistan. Sample size was 180 and the consent were taken from the participants prior from data taken. Questionnaire was adopted from previous study and data is analyzed through SPSS version 21. Statistics of the study shows that All of 180 students were female students, 77% participants having education level of FSc and take admission in Nursing Diploma. 86% of the participants fall in age group of 18 to 22. The Overall result shows that 89% of teaching behavior have string and positive relationship with students learning and it affect the students learning significantly and this is concluded from this study that the behaviors of clinical teaching faculty have positive relationship and influence students learning.

The aims of the present investigation were to evaluate (1) HIV/AIDS related knowledge, attitudes and risk perception among the physiotherapist in Chennai, Tamilnadu, India (2) to identify predictors of willingness to provide care for patients with HIV infection. A cross sectional survey was done among 300 physiotherapists working in different hospitals, physiotherapy clinics and institutions offering physiotherapy services in Chennai, Tamilnadu, India. The internal constancy for HIV/AIDS related knowledge was found to be 0.717. The attitudes and risk perception among the participated physiotherapists was found to be 0.723. The results indicated that HIV/AIDS related knowledge, attitudes and risk perception among the physiotherapist in Chennai Tamilnadu, India was acceptable. From the present investigation it was also found that there was significant association between physiotherapist’s attitude towards HIV/AIDS and their willingness to treat HIV/AIDS patients.

Nurses provide care to patients and they feel hope to get comfort and recover. Nurses use the knowledge and skills to provide care to the patients. There are many health care professionals who involved in providing care for sick patients but nurses are the central part of this process. There are many tasks which nurses have to perform in routine and medication administration is one of them. To assess nurses’ perception about medication administration errors and the factors that are associated with the medication packaging, physician communication, pharmacy process, nursing staff and medication administration. Descriptive cross sectional study design and quantitative survey technique was used in this study. The sample size of this study was 264. The self-administered questionnaire was distributed to 300 nurses of Children Hospital, Lahore, Pakistan through convenient sampling and all the participants were females. The study found that nursing related factor is the highest reason of the medication error among the nurses of the Children hospital Lahore, Pakistan. However, pharmacy is the lowest reason of the medication error. Thus, management should focus on the training and development of the nurses regarding medication error so that the better health care services can be ensured

We describe a rare case of hypertension and bilateral pleural effusion simultaneously in twenty-two years old otherwise healthy young female in March 2017. The patient presented with an allergic reaction to an insect sting. Hence, she developed a generalized rash and shortness of breathing where she received a methylprednisolone 80 mg intravenously every 8 hourly for five days where she was discharged home. However, the patient readmitted within 24 hours with non-resolving shortness of breathing, dry cough, hypertension and bilateral pleural effusions more significant on the right side are confirmed clinically and radiologically. Five days after methylprednisolone was discontinued, patient became normotensive and chest x-rays was normal. These manifestations that include symptoms, signs and radiological images and their resolutions are given a name of a syndrome called “Yahya Al –Fifi’s syndrome

This paper examines the impact of financial development on the rates of investment in physical and human capital, again with and without accounting for country fixed effects. The development of financial sector through effective utilization of domestic resources is vital for economic growth and poverty reduction. During the first half of the 1990s Bangladesh experienced major financial sector reforms which included the liberalization of interest rates, improvement of monetary policy, abolishing priority sector lending, strengthening central bank supervision, regulating banks, improving debt recovery and broadening capital market development. To the extent that financial development facilitates growth by encouraging factor accumulation; we should observe their impact in these direct specifications.

Service delivery is the most widely used measure of performance in the public sector. This paper is a critical review of literature with a focus on how service delivery is linked to leadership qualities, ethics and accountability. The four concepts explaining the variables under focus in this paper are introduced through a brief presentation. The study discusses theoretical perspectives deemed most appropriate for this work. These are the path-goal theory, resource based view and principal-agent theory. It is evident that there are numerous studies which have taken different methodology approaches and are conducted in diverse contexts. There however exist conceptual, theoretical, methodological and contextual gaps which need to be addressed in future studies. The key emerging knowledge gap is the fact that the available studies have not investigated the link between leadership qualities, ethics and accountability on one hand and service delivery on the other. Given the importance of improving service delivery it is therefore imperative for scholars and practitioners to understand the nature of this link and to explore it to improve especially with regard to the public sector entities. The review has developed a clearer understanding of the concept and how they relate with the theoretical perspectives. The review underscores the need for practitioners to work towards ensuring organisations are aligned with best practices for leadership qualities, ethics and accountability to ensure better service delivery. The review further highlights need for policy makers to put in place regulatory framework to nurture effective leadership, enhance ethics and accountability for better service delivery.

The quality of government is a key variable affecting the government's trust. Then, how to measure the quality of government? How to study the influence of government quality on government trust? This paper focuses on combing the research status of government quality and government trust at home and abroad, defines the concept of government quality involved in the article, and points out the importance of the division of government quality indicators. Through the literature review of the efficiency of the government, the rule of law, clean government effect on government trust, a general overview of the quality of government's trust in the government, provide basic materials for studying the relationship between government quality and government trust.

The government of Taiwan has promoted the hierarchy of medical care in Taiwan in order to facilitate large-scale hospitals returning to the nature of teaching research, emergency and critical care services. Since 2017, the clinical and service growth of mild cases at medical centers and regional hospitals has been limited. This study adopts a retrospective study and uses the clinic application number of the NHI-insured as research subjects. The subject hospital in 2016 applied about 838,088 cases, and after screening about 158,631 people times were included as the research subjects. With the Chi-square test, a significant difference has been identified in age (p<0.001), gender (p<0.001), diagnosis of diabetes, high blood pressure, and hypercholesterolemia (p<0.001), and divisions visited (p<0.001). 2016 Q1’s primary care services rate was 15.18% with the annual average of 18.93% lower than national rate at the same period, 21.76%. Patients of primary care can be transferred by hospitals to community clinics to reduce financial losses. Relevant adoptive measures also need to be introduced by the government (such as policy promotion and adjustment of co-payment) to smoothly promote and develop primary care services.

Abstract: This study is intended to Analyze the Influence of Product Quality, Quality of Service and Price to the purchase decision. The design of this research is quantitative by using the method. The population of this study is all pregnant women in Tangerang Selatan district, Julah pregnant mother in South Tangerang regency strength 5250 people. The sample size in this study using Slovin formula with α is used is 10%, thus the sample size is 98 people. This research uses multiple linear regression analysis technique. SPSS 20.00 analysis tool. The results of this study are Product Quality, Service Quality and Important and Significant Price to Purchase Decision. There are still other factors affecting the Purchasing Decision apart from the three variables of product Quality, Quality of Servicing, and Price.

Chronotherapeutics refers to a treatment method in which in vivo drug availability is timed to match rhythms of disease, in order to optimise therapeutic outcomes and minimise side effects. The term "chrono" basically refers to the observation that every metabolic event undergoes rhythmic changes in time. It refers to a treatment method in which in vivo drug availability is timed to match rhythms of disease in order to optimize therapeutic outcomes and minimize side effects. It is based on the observation that there is an interdependent relationship between the peak-to-trough rhythmic activity in disease symptoms and risk factors, pharmacologic sensitivity, and pharmacokinetics of many drugs. In this present study invivo evaluation of bilayered tablets of Losartan and Hydrochlorothiazide were studied on rabbits to prove that the prepared formulation shows a pulsatile drug release. The plasma levels were measured using LC-MS/MS method. Pharmacokinetic parameters of these tablets were determined by using WINNOLIN Scientific software. The pulsatile release tablet formulation prepared in the lab managed to show some lag phase initially before releasing the drug with a maximum time (Tmax) at the 12th hour. From this present work the results of invivo studies proved that chronotherapeutical release of drug in the form of bi layered tablet can be achieved for newer chronotherapeutical drug delivery system.

Abstract: A new effective method for pricing American option under the Black-Scholes model using pseudo inversion matrix is proposed and justified. The bases for a pseudo inversion matrix to price an American Option under the Black-Scholes model depend on the complete understanding of the discretization process and stability principles. For the past years, a lot of researchers have applied pseudo inversion matrix in solving system equations, like reconfigurable control system (RCS), Hermitian differential-algebraic system etc. This paper presents a simple pseudo inversion method for American option valuation under Black-Scholes model, through a drifted financial derivative system, discretized from Black-Scholes financial PDE. An illustrative example is given in concrete setting.

Epidemiological information on tuberculosis (TB) has always been vital for planning control strategies. It has now gained further importance for monitoring the impact of interventions to control the disease. The present study was done to estimate the prevalence of pulmonary tuberculosis in industrial population in a tertiary care centre in north India. It is a cross sectional study conducted at ESIC Medical college and hospital which caters to the registered /insured industrial worker under ESI scheme. All patients from chest clinic in the study period who were presumptive pulmonary TB patients were subjected to two sputum examination for AFB microscopy by ZN staining method. Demographic data of study subjects was collected, processed and statistical analyzed using SPSS software. Total 1315 patients participated in the study. Total sputum samples collected were 2623 out of which 351 were positive giving slide positivity rate of 13.58%. Among all of the total positive slides, male female ratio was 1.4:1. Maximum number of slide positive cases was present in 21-30 yr of age group in both male and female. 15.2% cases observed one of the two sputum samples as positive, thus emphasizing the importance of at least two sputum samples for diagnosis. The findings of this study reveal that younger age group patients 21-30 year old were most susceptible to tuberculosis and also percentage positivity of sputum among females was found significantly higher than males in the reproductive age group (21-50 yr). This finding, if corroborated in further studies could have major implications on the reproductive health of women

Abstract: Diabetic neuropathy (DN) is a common complication of both type-1 and type-2 diabetes, which affects over 90% of the diabetic patients. The distal symmetrical polyneuropathy (DSPN) is the commonest clinical form of diabetic neuropathy, affecting more than 90% of the patients. Painful diabetic neuropathy (PDN) is one of the most common of all type of the long-term complication of diabetes, affecting up to 50% of patients. The most common sites of pain are in the periphery involving the feet, toes, and hands. DNP continues to represent a therapeutic challenge as its pathophysiology is not yet fully understood and pain relief is still unsatisfactory. Clinical guidelines recommend pain relief in PDN through the use of antidepressants such as amitriptyline and duloxetine, the γ-aminobutyric acid analogues gabapentin and pregabalin, opioids and topical agents such as capsaicin. Of these medications, duloxetine and pregabalin were approved by the US Food and Drug Administration (FDA) in 2004 and tapentadol extended release was approved in 2012 for the treatment of PDN. This review does not widely discuss all possible treatments for painful neuropathy; however it provides a systematic approach designed to guide clinicians in tailoring therapies to the individual patient.