Abstract: Rheumatoid arthritis is an autoimmune disorder defined by erosive symmetrical poloarthropathy. It affects joints of hand and feet and also affects other organs. There has been a great deal of progress in the management of rheumatoid arthritis.Perioperative management of these patients is challenging.the anaesthesiologist must be aware of recent developments and potential risk of this multisystem disease.

Abstract: We search for non-zero distinct integer triples (a_0,a_1,a_2) such that each of the expressions a_0+a_1, a_0+a_2, a_1+a_2, 2(a_0+a_1+a_2) is a perfect square.

Abstract: Marijuana induce alteration Hypothalamus and pituitary function and altered subsequently T3, T4 and TSH. To assess the Thyroid profile level(T3, T4, and TSH) in marijuana abuse .This case control study includes 120 Sudanese males (60 of them were marijuana abuse were considered as study group, and the other 60 healthy subjects were considered as control group ;were they do not use marijuana). All subjects were sex and age matched (age ranging between 18-60 years).Study group have addiction period between 1-37 years. This study carried in Alribatt hospital, Khartoum, from May to August 2015, serum was collected from both group and the concentration of T3, T4, and TSH were estimated using ELISA Bio TeK. There were a significant decrease in the level of the of T3, and TSH in marijuana abuse in comparsion with the control group where the (mean ± SD) was (1.25±1.77, 1.18±.69) for T3 and TSH respectively while the controls group had (mean ± SD) (1.04±.30, 1.91±1.21) for T3 and TSH respectively with p- value (0.00). But there was no significant difference in the level T4 when compared with the control group (9.99±4.16, 9.47±2.93) with p-value (0.19). This study concluded that T3 and TSH were highly significant decreased, but T4 were had insignificant change.

Abstract: Marijuana affects a variety of hormones that are regulated by hypothalamic function and it appears that the psychoactive ingredient, THC, is the major compound responsible for this action. To assess of LH, FSH, and Testosterone level in marijuana abuse. This case control study includes 60 marijuana abuses from Elribat hospital as case study. These patients are compared with age and sex matched with 60 healthy subjects as controls. All volunteers age ranging between 18-60 years. Blood samples were collected from all subjects, then serum concentration of LH, FSH, and testosterones were estimated using ELISA Bio TeK. There were a significant decrease in the level of LH, FSH and testosterone in marijuana abuse in comparison with a control group where the (mean ± SD) of LH, FSH, and Testosterone in marijuana abuse people were (4.9±1.9, 3.3±1.9, 19.3 ± 6.1) respectively while the (mean ± SD) of control group were (5.9±3.62, 6.9±3.6, 22.5±9.5) for LH, FSH, & Testosterone respectively. This study concluded that (LH, FSH and Testosterone) level were highly significant decreased in marijuana abuse.

Abstract: Tax non-compliance reduces tax collection and the tax performance within a country. The Kenyan government has implemented various strategies to bring businesses in the informal sector into the tax bracket. However, available data shows that tax collections from the informal sector are above average but on a declining trend. The purpose of this paper is to determine influence of tax rates on tax compliance in the informal sector in Nyeri town. The study adopted a cross-sectional survey design and targeted 715 informal businesses in Nyeri Town. Stratified random sampling technique was used to select 143 informal businesses to participate. Researcher-administered questionnaires were used to collect data from the respondents. Descriptive methods such as frequency distribution, percentages, mean, were used to summarize and organize data. Chi-square tests and correlation analysis were employed to establish relationships between study variables. Findings were presented using tables of frequencies and percentages. Majority (74%) of the respondents indicated that they tried their best to comply with all tax procedures. Results revealed that Majority (75%) of the respondents indicate that the taxes charged were too high. Tax rates (p=0.000) had a significant relationship with tax compliance at 95% confidence level. The study cited that tax rates were important predictors of tax compliance in the informal sector. It was recommended that tax rates should be reviewed for those in the informal sector to ensure that they commensurate with economic conditions.

Abstract: We describe the case of a patient with Neurofibromatosis type 1 (NF1) and Secondary Hypertrophic Osteoarthropathy. On this association so far, hypertrophic osteoarthropathy seems to be related to the vascular involvement of Neurofibromatosis wherein some studies reveal release of PDGF (platelet derived growth factor) by the neural tumor.In order to exclude other causes of secondary Hypertrophic osteoarthropathy all possible causes were excluded.On the basis of clinical findings and exclusion of all other causes, and no literature or case reports suggestive of presence of Hypertrophic Osteoarthropathy in Neurofibromatosis type-1, this finding attains animportant clinching and rare clinical entity and also signifies to include one among the neurological causes of secondary Hypertrophic Osteoarthropathy. The possible pathophysiology of Hypertrophic Osteoarthropathy in patient with neurofibromatosis has been discussed.

Abstract: TruScreen is a unique electro-optical technology that provides a direct means of tissue differentiation as a primary screening tool in the general population for cervical cancer and precancerous change (CIN). Objectives of the work are evaluation of sensitivity and specificity of the optoelectronic method in the detection of CIN and cervical cancer. The present study shows correlation between the pNOR number and sensitivity/specificity of the optoelectronic method. The study included 293 patients with abnormal cervical cytology result and the following examinations: examination with the use of the optoelectronic method – Truscreen, colposcopic examination, and histopathologic biopsy. Specificity of the optoelectronic method for LGSIL was estimated at 65.70%, for HGSIL and squamous cell carcinoma of cervix amounted to 90.38%. Specificity of the optoelectronic method used to confirm lack of cervical pathology was estimated at 78.89%. The field under the ROC curve for the optoelectronic method was estimated at 0.88 (95% CI, 0.84–0.92) which shows high diagnostic value of the test in the detection of HGSIL and squamous cell carcinoma. The optoelectronic method is characterized by high usefulness in the detection of CIN, present in the squamous epithelium and squamous cell carcinoma of cervix. In conclusion, we suggest that TruScreen holds the potential to detect lesions that might be missed by cytology alone and clarify unsatisfactory or ASCUS cytology results. With regard to patients, they can benefit from more rapid follow-up and early treatment. We also noticed that the women were happy with the real time results, which are now available using TruScreen. TruScreen technology seems to have a high potential to improve and standardize the screening of the cervical carcinoma.

Abstract: Equality between men and women is a fundamental right and a common policy of many governments in the world today. Gender mainstreaming is the process whereby gender concerns are raised routinely within everyday operations of an institution or organization and resolved in a gender manner in normal operations. The well-being and the equality between men and women are addressed by gender mainstreaming. The purpose of this study was to establish the effectiveness of gender mainstreaming initiatives employed in enhancing gender equity in the Ministry of Agriculture, Livestock and Fisheries in Kirinyaga County, Kenya. The specific objectives of the study were to establish how recruitment and selection, employee awareness, a gender office and implementation of gender mainstreaming policy affect gender equity in Ministry of Agriculture, Livestock and Fisheries in Kirinyaga County. The study employed a descriptive survey research design and targeted all fifty (50) Ministry employees. Descriptive data analysis was done which generated mean and standard deviation with the help of Statistical Package for Social Sciences (SPSS). Frequencies and percentages were also generated. The study established that there was a close relationship in terms of proportions of the respondents between a yes (54%) and no (46%) responses on training.The study established that the Ministry ensured fair recruitment and selection based on Gender Equity to a great extent (36%).It is therefore recommended that the Ministry through their Cabinet Secretary provides statistics of the incoming employees based on gender. The researcher also recommends that the Ministry clearly outlines what constitutes gender mainstreaming training. The study also found out that the Ministry of Agriculture, Livestock and Fisheries had neither done much (40%) on sponsoring gender balance awareness training nor done much(34%) on implementing gender balance awareness training. The researcher therefore recommends that awareness training should be enhanced.

Abstract: The financial cost of seeking formal health care is often the major barrier to accessing health care in poor countries. Consequently, the governments of several developing countries have introduced free health care in an effort to improve their nation's health. There is evidence that suggests that many Ghanaians patronise both indigenous and orthodox health facilities simultaneously. On the 30th of June, 2015, The Bongo District Hospital prompted the Bongo District Health Directorate (DHD) that they had recorded a positive case of cholera from Kantebge’s house at VeaGunga, in the Bongo District of the Upper East region of Ghana. Weinvestigated to verify the diagnosis, identify risk factors and recommend control measures.We conducted a descriptive investigation and active case-search.We defined a cholera case-patient as a person with vibrio cholera isolated from stool sample or epidemiologically-linked to a person with vibrio cholera from the 1st of June to 20th of July at Valley View Sub-district of Bongo district.Stool from case-patients were taken for laboratory diagnosis. We performed univariate analysis by person, place and time using Epi-info version 3.3.The result of the 933 community members, 13 were affected. The overall attack rate was 1.4% (13/933) with a case fatality 15.4% (2/13). The mean age of case-patients was 28.5 years (±18 SD) with females 69.2% (9/13) mostly affected. Sex specific attack rates were 0.9% (4/447) and 1.6 % (9/486) for males and females respectively. The index case was 45yr-old man who reported at the Bongo District Hospital on the 30th of June. He took care of the primary case and also participated in the preparation and burial of the corpse. All the cases were recorded from VeaGunga, in the Bongo District. Vibrio choleraeserotype ogawa was isolated from stool samples. It was a point source outbreak that affected mainly women from the community. It is however hypothesized that the source of infection could be from the beans cake, the water from the Vea Dam or the primary case being a vibrio cholera carrier. Two (2) persons died as a result of taking some local concoction due to lack of money and the national health insurance scheme.An outbreak of ogawa serotype cholera with some fatalities was established in Vea-Gunga community in the Bongo district of the Upper East region. It was a point source outbreak that affected mainly women from the community. It is however hypothesized that the source of infection could be from the beans cake, the water from the Vea Dam or from avibrio cholera carrier. The need for health care financial protection and avoidance of concoctions in the management of cholera case patients are basic requirements in avoidance of unnecessary death. Prompt outbreak response, case management and education about causes and prevention of diarrhea played a significant role in controlling the outbreak.

Abstract: Performance contract is a management tool for measuring freely negotiated performance targets between institutions management and the Government. Performance Contracts have been used in many enterprises in the world. Performance contract was introduced by the Government of Kenya to ensure delivery of quality service to the public as well tertiary institutions also known as TIVET institutions. The purpose of this study was to investigate the effects of managerial knowledge and information on the implementation performance contract in Tertiary institutions in Meru County. The specific objectives of the study were: to determine find out the effect of managerial knowledge on implementation of performance contract in tertiary institutions in Meru County, and to evaluate the effect of information on implementation of performance contract in tertiary institutions in Meru County. The study adopted a survey research design and stratified sampling technique was used to draw a sample size of 63 from a population of 76 employees of tertiary institutions in Meru County. Data was collected using a questionnaire and the interviews. Data analysis was done using SPSS software; correlation coefficients were used to determine the nature of the relationship between the dependent variable and independent variables. Chi-square analysis will be done to test significance of variables. The findings were presented in tables and figures. The study of the findings were considered important for gathering information for managerial policy decision making that enabled the managers understand the positive approaches towards performance contracting as a management tool for improving performance in tertiary learning institutions which has continuous benefits to the long-term development. The findings of this study were; Managerial knowledge of PC coordinators affects the implementation to a very great extent and there is an association between managerial knowledge and the implementation of performance contracts {(χ2 (1,4) = 56.448, p< 0.05)}. There is a significant association between policies and procedures and the implementation of performance contracts. In the view of the findings the study recommended principals of tertiary institutions should organize continuous in-servicing of officers on performance contracting so as to improve their knowledge on the same and the managers should always induct the junior mangers on implementation of performance contracts.

Abstract: True hermaphrodite have gonads of both sex in the same individual. They contain ovary and testis with ambiguity of genital organs. We report a case of true hermaphrodite in a male patient of 26 years having absent of beard and moustaches, medium pitch voice , partial fusion of labia majora and testis, enlarged clitoris with non penile urethra, no vaginal and opening having uterus.

Abstract: An audit is an independent examination of account of an entity done by an independent auditor in other to ascertain the truth and fairness of the financial statement. This paper tries to explore the content of public and private audit in Nigeria. Various laws and enactment were view as what are the requirements of public as well as private audit. It was found out that both of them are two bird of the same feather. They are all governed by the professional pronouncement as well as the financial reporting standard of Nigeria. Although, but the parties maintain the code of ethics of the profession which include: Independence, Integrity, Confidentiality and professional duty and care. It was recommended that strengthening the independence of the supreme audit institution, and reinforcing the PAC to be alive to its responsibilities and improving the accounting environment. Also external audit should maintain the ethics of the institution toward rendering of their duties.

Abstract: The objective of this study was to evaluate the effects of tramadol, a centrally acting synthetic opioid analgesic, on glutamate metabolism, without inducing pain. Male adult Wistar rats weighing 150 ± 20 g were used in the study. An effective dose of tramadol was injected subcutaneously into the rats at 0, 24, and 48 hours, and the changes in the levels of activities of glutamate dehydrogenase (GDH), glutamine synthetase (GS), glutaminase, aspartate (AAT) and alanine (AlAT) aminotransferases, and glutamine content, were recorded at 3, 6, 12, 24, 48 and 72 hours in different areas of the rat brain, viz. cerebral cortex, cerebellum, pons-medulla, hippocampus and hypothalamus. Aminotransferase activities were examined in serum also. Following the first administration of tramadol at zero hours, GDH activity showed positive deviations in all areas except pons-medulla, GS activity showed positive deviations in all areas, glutaminase activity showed negative deviations in all areas except pons-medulla, and glutamine content showed positive deviations in all areas except hippocampus, up to 12 hours. Aminotransferase activities showed differential deviations, with increases in some areas and decreases in the others. Peak deviations in all cases occurred either at 3 or at 6 hours. All parameters reverted towards near control levels by 24 hours. Following the second and third injections of tramadol at 24 and 48 hours respectively, the parameters recorded deviations at 48 and 72 hours that were slightly reverting from those at 24 hours. The results indicate differential tissue responses from different areas of the brain to the administered analgesic. Further, while the administration of opioids could affect the glutamate release vis-à-vis reuptake and the activation of N-methyl-D-aspartate (NMDA) receptors, these changes could presumably be associated with alterations in the levels of other parameters related to glutamate metabolism. This could be another facet of the analgesic effects of tramadol.

Abstract: In this paper, we propose a new non-monotone self-adaptive trust region method with line search for solving unconstrained optimization problem. Different from the usual trust region methods, our algorithm does not only use a non-monotone technique, but also use a new rule to update the trust region radius. We prove the global convergence of the new algorithm under some reasonable assumptions.

Abstract: The objective of the study was to evaluate the phytochemical and in-vivo antihyperlipidemic activity of Solanum spirale Roxb. leaves. The physiochemical standardization of the dried leaves powder was done with respect to ash values, foaming index, extractive values and moisture content. The dried leaves were extracted with petroleum ether, chloroform and water. The phytochemical analyses were carried out and the antihyperlipidemic activity of the chloroform and aqueous extracts were evaluated. The antihyperlipidemic study was carried out by inducing hyperlipidemia in rats by means of triton. The serum collected was analyzed for total cholesterol, triglyceride, low density lipoprotein, and high density lipoprotein. The result of the present study revealed that both the aqueous and chloroform extracts of leaves of Solanum spirale Roxb. possess antihyperlipidemic activity.