Flow cytometry (FCM) is a unique technique that allows rapid quantitative measurement of multiple parameters on a large number of cells at the individual level. FCM is based on immunolabelling with fluorochrome-conjugated antibodies, leading to high sensitivity and precision while time effective sample preparation. FCM can be performed on tissue following enzymatic or mechanical dissociation. The expression of epithelial antigens and cytokeratin isoforms help in distinguishing tumor cells from adjacent epithelial cells and from tumor infiltrating leukocytes. Tumor phenotypes can be characterized on expression intensity, aberrancies and presence of tumor-associated antigens as well as their cell proliferation rate and eventual heteroploidy. FCM can measure quantitative expression of hormone or growth factor receptors, immunoregulatory proteins to guide adjuvant therapy. Expression of adhesion molecules tells on tumor’s capacity for tissue invasion and metastasis seeding. Tumor heterogeneity can be explored quantitatively and rare, potentially emerging, clones with poor prognosis can be detected. FCM is easily applicable on fine needle aspiration and in any tumor related biological fluids. FCM can also be used to detect circulating tumor cells (CTC) to assess metastatic potential at diagnosis or during treatment. Detecting CTC could allow early detection of tumors before they are clinically expressed although some difficulties still need to be solved. It thus appears that FCM should be in the pathologist tool box to improve cancer diagnosis, classification and prognosis evaluation as well as in orientating personalized adjuvant therapy and immunotherapy. More developments are still required to better known tumor phenotypes and their potential invasiveness

Foreign body ingestion in children is a serious problem encountered among children. Approximately 80% of cases of foreign body ingestions occur in children between the ages of six months and three years [1]. Button battery ingestion occurs at an estimate rate of ten in one million people per year, a small group of which are retained in the esophagus and later become complicated [2]. Button battery ingestion can lead to esophageal perforation and death within hours if not appropriately diagnosed [3].

According to raising teenage parents though their abusing and neglecting children at a rural community with the ethnographic qualitative research method was surveyed. All children have protected on violence, abuse, neglect and exploitation from their teenage parents. To investigate and emphasize the consequences of violence ranged from immediate to the impact of their development on physical injury, learning ability, and local child care performance to long-term harm that caregivers carry into adult life is affected for raising children. Administration to the 89-households’ families and household memberships, 10 house stakeholders, 8 community leaders, 36 children, 65 caregivers, teenage parents and grandparents, and 3 mentors. Using the ethnographic qualitative research participatory with observation, natural conversation and in-depth interviews were randomized in rural Northeastern Region, Thailand. There are 52% of children being sexually, physically, or psychologically abused, neglected per day. Most of the teenagers’ education is poor learning skills, low academic learning achievements, and independent freedom of their sexual behaviors. These sexual intercourses between their groups are normal. Adding gambling habits among friends and adult groups are amputated without parents to dissuade. Either lifestyles as freely with sexually and gambling and the basic education are stopped, experiences’ living skills are poorly. Teenage women are changed to pregnant and young mothers. The teenage men must be searched for the job without a lack of worker’s skills to look for children with whom they are conflicted family relationships to take care.

The global identities of parents’ popularity in rural communities to make-decision effects of their attitudes to transfer their Early Childhood from Child Development Centres and Local Primary School for moving study into the schooling cities that looks like children’ asylum of their educational conditions, problems, administration’ school directors, teachers, and schools’ environments to protect that described. The involving CDCs’ perceptions got using the 25-item My CDC Identity Inventory (MCDCII) in five scales, three options. Teacher and Caregiver-Early Childhood interactions have assessed with the 30-item Questionnaires on Teacher Identity Interaction (QTII) in five scales on five options. The 10-item Local Identity-Related Attitude (LIRA) has been associated with a sample of 300 children’s parents, teachers, and caregivers. The determination of efficient predictive value (R2) shows that 30% of accepted the identities on cohesiveness, competitiveness, physical indoor and outdoor environmental development, satisfaction, and strong-sense identity. 74% of their CDCs can protect the educational asylum of early childhoods from rural communities. The R2 value shows 49% of the variance in children’s parents’ perceptions was because of the MCDCII have associated. Despite Thailand’s success in expanding educational access, new empirical evidence suggests that much more needs to be done to maximize the potential of its students. The performance gaps among schools have disadvantaged and poorer-performing students have concentrated in small rural village schools. The Thai pre-primary school system is dramatically lacking in qualified the CDCs’ learning environments and achievements, and teachers. It allocated small rural schools teachers with lower qualifications and teaching experience.

This study aims to assess parents’ perceptions of their responses to the perceived awareness programme competency abilities and expectations for enhancing parents on weight control of their pre-school children in preventing with Obesity. It has defined self-efficacy as one’s belief in one’s ability to succeed in specific situations and accomplish a task with the theoretical framework of Bandura’s Model by quasi-experimental research in 16 weeks. To promote the self-efficacy and expectations, the 10-item Questionnaire on Self-Efficacy Program, the 22-item Questionnaire on Parents’ Efficacy Interaction, and the 46-item Questionnaire on Parental Expectations assessed parents’ perceptions. A sample size consisted of 14-pre-school children whose age ranged 2-5 years old at the Child Development Demonstration Centre, Khon Kaen University was selected. Providing knowledge, teaching, demonstration, experimentation, and organized activities were organized. Parents’ perceptions of their abilities for controlling children’s weight and height with pre- and post-experimental programmes differentiated, significantly. Parents’ responses to the post performances are over than pre-experiment for the QSEP, the QPEA, and the QPE, differently. They answered and followed up on child management with parents online for 16 weeks, continuously. The obese early childhood at the CDC Demonstration Centre, Faculty of Nursing used the food programme to self-efficacy with their parents taking part and cooperating well in specifying research objectives. There are 2,958,441 children in rural areas are lacking attention, because of food and health problems in the 19,171-Child Development Centres none yet have food programmes to prevent health and hygiene problems. Although Thailand took the next leap forward for its investment in Early Childhood Development through legislation, improved quality services, and social transfer grants for families with young children since 2018.

The impression of frictional ridges of the finger is known as fingerprints. Owing to this uniqueness, the fingerprints have long been used to identify a person since Ancient times. In any crime scene the presence of fingerprint makes the identification of the Culprit very easy. The fingerprints can also easily be embedded on any item such as paper, Clothing and body of the victim. To utilize this uniqueness of fingerprints forensic experts devised many techniques to obtain a clear fingerprint. These come under two categories i.e. Conventional and modern methods. The conventional methods are although important but there are limitations of them. Just take the example of powder method. Powder method require different powders for different Surfaces and colors, but modern method like quantum dots method can easily detect Fingerprints on all surfaces regardless of their color giving great resolution in seconds. Other methods like physical developer method is very time consuming and expensive, carbon Black method creates mess and does not work on porous surface, iodine fuming and Naphthaloflavin does have an advantage that it can bring up prints on skin also but it does not Work on metallic surfaces. VMD also fails on heavy plastic polymers and body oils. But some modern methods like nanotechnology can obtain high resolution prints old and dried prints also within 3 minutes. Laser technology is very fast, accurate and can be used for Fingerprints up toten years old also on any surface without any mess. Multimetal deposition Method can even be used to identify smokers and drug addicts and can be used Porous, non-porous and wet surfaces.

Development of genetic profiles from the biological mixtures has remained challenging, although modern-day technologies may help forensic scientists to attain a reliable genetic profile in the identification of the accused. In the case of rape, vaginal swab exhibits usually contain epithelial cells of victims and sperm cells of accused, such samples are more challenging when there is more than one contributor. In such cases, separation of distinct cells from a mixture that includes blood cells, epithelial cells and sperm cells for their single genetic profile is important. In the last ten decades several new techniques were developed and invented for the separation of single cell from the biological mixture that includes differential lysis, laser micro-dissection, cell sorting (FACS), sieve-based filtration, (vi) micro-fluidic devices or immunomagnetic beads cell separation of fresh samples, and the magnetic activated cell sorting (MACS). Out of them, some techniques have been commonly applied for cell separation in forensic biology. Each technique has its own limitation. Some recent studies showed, magnetic activated cell sorting (MACS), laser capture microdissection (LCM), DEPArray technology and fluorescence activated cell sorting (FACS) has proved to be effective in separation of single cell from cell mixtures. Therefore, in this review we have evaluated these four alternative methods and their potential application in the modern-day over the others for the separation of a single cell from the mixture. In this review we also discuss the advantage of these methods and their modern–day applicability and acceptance in the forensic world.

Introduction: The tendency to impulsive behaviors and/or violence is exacerbated after alcohol consumption. Still, the relation between alcohol/violent deaths reported in the literature is not accurate, and in general, alcohol is only seen as a trigger to aggressive actions. The relationship of the victims with their blood alcohol is less studied. They were especially concerned about the role of alcohol as a risk factor for victims of unnatural death. Thus, our goal is to check the influence of alcohol in victims of violent deaths as homicides, suicides, and accidents. Materials and methods: Retrospectively the medical records of 805 autopsies performed at the Institute of Forensic Medicine (IML) of Franco da Rocha, in the period 2001 to 2017 were reviewed. The variables studied were sex, age, types of violent death rates, and alcohol - these were considered positive when above 0.3 mg/ml. The dosage of blood alcohol concentration (BAC) was performed using samples of 10 ml of blood collected at necropsy, is preferably taken from the cardiac chambers or of the right femoral vein. Dosages of alcohol in blood samples were done in the Forensic Toxicology Center of the IML by gas chromatography, using the technique of separation “headspace” and double column. Results: Drug testing for alcohol was available for 488 (79.1%) of 617 necropsies. Of the 617 subjects studied, 532 (85.7%) were male, and 85 (13.8%) were females (with high rates of adolescents). The vast majority (n = 230) were killed, and 40.5% of victims had BAC above 0.3 mg/ml of blood. Traffic accidents came next, accounting for 181 deaths, with 41% of victims presenting positive BAC. Discussion: High blood alcohol levels of the victims were associated mainly with the genesis of accidents (drowning, falls, traffic, aspiration/ smothering) and murder (with impaired ability to resist or by causing the release of impulses to engage in violent situations), about 40% of cases. Conclusion: Our results indicate that alcohol abuse is a risk factor for victims of violent death. In these cases, alcohol has two types of action. Direct: contributes to accidents of various kinds - from traffic by decreasing powers of concentration, attention, and loss of reflexes, to other types of accidents such as drowning, falls, swallowing disorders causing airway obstruction, and mechanical asphyxia. And they were indirect, making it easier for individuals to engage in conflict (and thus become victims of crimes).

Background: In developing countries, manual small incision cataract surgery is a better alternative and less expensive in comparison to phacoemulsification and thus the incision is an important factor causing high rates of postoperative astigmatism resulting into poor visual outcome. Thus, modifications to the site of the incision is needed to reduce the pre-existing astigmatism and also to prevent postoperative astigmatism. Modification to superotemporal incision relieves pre-existing astigmatism majorly due to its characteristic of neutralizing against-the-rule astigmatism, which is more prevalent among elderly population and thus improves the visual outcome.Aims: To study the incidence, amount and type of surgically induced astigmatism in superior and superotemporal scleral incision in manual SICS.Methodology: It is a randomized, comparative clinical study done on 100 patients attending the OPD of Ophthalmology at a tertiary care hospital, with senile cataract within a period of one year and underwent manual SICS. 50 of them chosen randomly for superior incision and rest 50 with superotemporal incision. MSICS with PCIOL implantation were performed through unsutured 6.5 mm scleral incision in all. Patients were examined post-operatively on 1st day, 7th day, 2nd week and 4th week and astigmatism was evaluated and compared in both groups.Results: It is seen that on postoperative follow up on 4th week, 77.78% of the patients with ATR astigmatism who underwent superior incision had increased astigmatism whereas, only 13.63% of the patients with ATR astigmatism who underwent supero-temporal incision, had increased astigmatism but 81.82% had decreased ATR astigmatism. However, 77.78% of the patients with preoperative WTR astigmatism who underwent supero-temporal incision, had increased astigmatism, whereas 44.45% of the patients with WTR astigmatism preoperatively, had increased astigmatism in contrast to 50% had decreased amount of astigmatism. It is also seen that the supero-temporal incision group had more number of patients (78%) with visual acuity better than 6/9 at 4th postoperative week than superior incision group (42%).Conclusion: This study concludes that superior incision cause more ATR astigmatism postoperatively whereas superotemporal incision causes lower magnitude of WTR astigmatism, which is advantageous for the elderly. Besides superotemporal incision provides better and early visual acuity postoperatively.

Introduction: A dermoid cyst is a developmental choristoma lined with epithelium and filled with keratinized material arising from ectodermal rests pinched off at suture lines. These are the most common orbital tumors in childhood. They are categorized into superficial and deep. Superficial orbital dermoid tumors usually occur in the area of the lateral brow adjacent to the frontozygomatic suture. Infrequently a tumor may be encountered in the medial canthal area [1], which is the second most common site of orbital dermoids. We report a case where a swelling presented in the medial canthal area without involving the lacrimal system. Case report: A 43 year old lady presented with complaint of swelling near the (RE; Right eye) since 2 years duration. She presented with a solitary 1.5 cm x 1 cm ovoid, non-tender, non-pulsatile, firm, non-compressible mobile swelling with smooth surface over the medial canthus of right eye. (MRI; Magnetic Resonance Imaging) brain and orbit showed right periorbital extraconal lesion and the (FNAC; Fine Needle Aspiration Cytology) suggested of Dermoid Cyst. RE canthal dermoid cyst excision was done under Local Anasthesia. Conclusion: Complete surgical excision in to be treatment of choice for dermoids. Since medial canthal mass can involve the lacrimal system, it becomes necessary to perform preoperative assessments using (CT; Computed Tomography), MRI or dacryocystography while planning the surgical approach. Silicone intubation at the beginning of the surgery is an easy and effective way of identifying canaliculi and of preventing canalicular laceration during dermoid excision if the lacrimal system is found to be involved.

Solid tumor oncology treatments are primarily performed in the outpatient setting. However, hospitalizations are inevitable due to complications of cancer and treatment-related toxicities. With rising health care spending, the length of hospital stay (LOS) is increasingly considered a proxy for healthcare costs. There are several ongoing efforts to abbreviate the inpatient LOS and ensure a safe and timely discharge to the outpatient setting. In addition to the acute illness and the associated comorbidities, various factors affect the LOS: social determinants of health (SDOH), nutritional status in cancer patients, and end-of-life issues. Furthermore, it is unclear how the institutional policies on social distancing and visitation during the current coronavirus disease (COVID-19) pandemic may impact the LOS. The purpose of this article is to review various factors and barriers that lead to longer LOS for solid tumor patients during the COVID-19 pandemic, and identify the critical areas of quality improvement.

Introduction: Cancer treatment and prognosis depend heavily on early detection. Survival in the early stages is excellent for almost all types of cancer. Unfortunately, in Saudi Arabia, a large number of cancer patients present with advanced disease, resulting in a poor prognosis. There are three levels of delay in the management of cancer patients. The first level is the time between the first cancer-related symptoms and the presentation to the health facility, the second level is from the presentation to the diagnosis, and the third level is between the diagnosis and the treatment. This study aims to determine if there is a delay, at what level and to study the factors causing such delays.Materials and methods: Two hundred cancer patients who presented to the Armed Forces Hospital Southern Region, Oncology Department, were interviewed from January 1st to June 30th, 2018. The interviews were conducted by trained physicians familiar with the questionnaire’s contents. The questionnaire consisted of four sections: a demographic section and three more sections to identify factors causing the delay at the three levels from the patients’ perspectives. All data were analyzed using the SPSS version 20.0.Results: The mean patient age was 63 years. A total of 112 patients were female and 88 were male. The most common cancer type was breast cancer (27.5%). Among the patients, 61% were illiterate and 25.5% had elementary school degrees, 86% expressed little or no general medical knowledge about cancer. More women than men paid attention to cancer symptoms (70% vs. 54%). 75% of the patients presented to the first health facility after 2 months from the first appearance of symptoms (level 1 delay). Only 2% of the patients presented within one week. 50% of the patients received a diagnosis after visiting two health facilities. All patients were diagnosed at hospitals. 40% of patients used alternative medicines, 70% of whom thought this was the cause of their delayed presentations. 67% had their diagnosis confirmed within one month (level 2 delay), and 66% started their definitive treatment within one month (level 3 delay). 75% of the patients blame themselves for the delay. Educational level (p = 0.03), knowledge about cancer (p < 0.01), and the use of complementary and alternative medicines (CAM) (p = 0.01) were significantly associated with delayed presentation of patients to the health facility. Conclusion: There is a delay in the presentation of cancer patients (level 1) in the southern part of Saudi Arabia. Educational level, knowledge of cancer symptoms, and use of complementary and alternative medicines are the main causes. There were no delays in diagnosis and start of treatment (level 2,3).

The paper analyses performance boundaries of systems converting the heat energy into the mechanical or separation work. Authors approach this problem from the view-point of the finite-time thermodynamics. Using thermodynamic balance equations, authors provide the algorithm for calculation of realizability domain for such systems. The paper shows that the performance of these systems is the upper bounded function of the heat flux, assuming that heat and mass transfer coefficients are given. Authors present sufficient conditions under which the efficiency (specific heat flux per unit of the useful flux) of the system does not depend on kinetic coefficients when operating in the maximum performance mode. The paper shows how to use these conditions to optimally choose the separation order for multicomponent distillation.

Strobilurin is a group of natural products and their synthetic analogs have been widely used to control and prevent fungal diseases. Strobilurins were firstly isolated in 1977 from the mycelium of Strobilurus tenacellus, a saprobic Basidiomycete fungus causing wood-rotting on forest trees. This group of pesticides was designed to manage fungal pathogens classes such as Ascomycetes, Basidiomycetes, and Oomycetes. Also, Strobilurin commercialized included derivatives such as are azoxystrobin, kresoxim-methyl, picoxystrobin, fluoxastrobin, oryzastrobin, dimoxystrobin, pyraclostrobin and trifloxystrobin. This group is a part of the larger group of QoI inhibitors, which act to inhibit the respiratory chain at the level of Complex III. Strobilurins group control an unusually wide array of fungal diseases, included water molds, downy mildews, powdery mildews, leaf spotting and rusts. This group are used on cereals, field crops, fruits, tree nuts, vegetables, turfgrasses and ornamentals. Also, Strobilurins found to enhance the plant growth in some cases.

Uterine leiomyosarcoma (LMS) is uncommon tumour arising from the female reproductive tract. Incidence of LMS in pregnancy is extremely rare, with only 10 cases reported thus far in medical literature.We present a case of myomectomy performed during elective caesarean section for breech presentation, due to its easy accessibility and well contracted uterus. Subsequent histology revealed LMS on final specimen. Patient subsequently underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy. No chemotherapy was given as she opted for close clinical- radiological monitoring instead. This case report highlights the importance of discussion with patients regarding the risk of occult malignancy in a fibroid uterus. Appropriate management of uterine leiomyosarcoma in pregnancy remains unclear. Consideration of removing an enlarging leiomyoma during caesarean section might be ideal in view of its malignant potential, just like in this case; however, location of the tumour and risk of bleeding needs to be weighed. Ultimately, management of such cases needs proper discussion between obstetrician and the patient.

A 3-year-old non-lactating pet goat was referred to our clinic due to advanced ocular lesions and blindness of the left eye (Figure 1). According to the case history, two weeks ago, a grass awn penetrated and injured the eye. The awn was removed by the owner immediately. The following day, the goat had serous ocular discharge and photophobia and was referred to a private veterinarian. The veterinarian did not find any remaining piece of the awn and prescribed tetracaine eye drops to be administered twice a day for the next 4 days. The treatment was not successful and the eye’s condition deteriorated the following days.

We describe a patient who developed severe retroperitoneal and intraperitoneal bleeding complicating femoral arterial catheterization for Percutaneous coronary intervention. Balloon tamponade of the actively bleeding femoral artery was effective in sealing off the leakage.This management strategy for this problem emphasizing an anatomical based interventional approach if the patient does not stabilize with volume resuscitation.

Introduction: Despite advances in the management of sickle cell disease (SCD), gaps still exist in the knowledge of healthcare professionals (HCPs) about the disease. The objective of this study was to assess the knowledge of HCPs about SCD. Methods: This is a cross-sectional study involving 465 HCPs (physicians and nurses) who responded to the DFConhecimento instrument questionnaire. Performance was tested in terms of average score and proportion of correct response for each questionnaire item topic. Results: The average score for respondents was 4.6 ± 1.9 out of a total of 13 points. Proportions of professionals who responded well were greater than 58% in three topics (Neonatal screening program, Sickle cell conditions, and Sickle cell anemia genotype). In the other topics, rates of good response ranged from 11.6% to 46.0%. There was a statistical association between best performance and medical title: physicians were more knowledgeable than nurses (OR = 6.26; 95% CI: 2.69-14.56). Conclusion: This study highlighted that knowledge of SCD among HCPs is very inadequate. This lack of sufficient information on SCD from HCPs indicates the need to develop continuing education programs.

Presently Packaging plays a significant role for Biosimilar product. The process of selecting materials and the type of packaging also offers an opportunity for the Packaging scientist to look for new biological delivery choices. Most injectable protein products were supplied in some sort of glass vial, prefilled syringe, and cartridge. Those product having high Ph content there is a chance of “delamination “from inner surface of glass vial. With protein-based drugs, the biggest issue is the effect of packaging derivatives on the protein’s three-dimensional and surface structure. These are any effects that relate to denaturation or aggregation of the protein due to oxidation or interactions from contaminants or impurities in the preparation. The potential for these effects needs to be carefully considered in choosing the container and the container closure system to avoid putting patients in jeopardy.

Considering the geographical complexity and adversity, online communication and consultation are viable method in Nepal. The COVID-19 pandemic has accelerated the already starting trend of use of these technologies in medicine. In BPKIHS, telemedicine efforts were already initiated; lockdown rather warranted its maximum use. Here is an account of the observation made in telepsychiatry service provided by a consultant psychiatrist of its department of psychiatry. It is an institute-based observation noted for all the telepsychiatry consultations in 9 random duty days of the COVID-19 pandemic. Basic necessary information was noted down in a semi-structured proforma, like: socio-demographic, clinical information and advice provided. There were 104 subjects; 73 follow-up and 31 new: 60 male and 44 female cases. Clients of multi-ethnic groups were the most from urban, then semi-urban and least from rural areas. More consultations were for young age-groups and from nearby districts of Sunsari. Mood, somatic (sleep), anxiety were the top presenting complaints and 8/104 clients had suicidal symptoms. Maximum follow-up cases were improving. The most common diagnoses were: Mood (Depression and Bipolar), Anxiety, Psychosis and Substance use disorders. Most common treatment advices included: Antidepressants, Antipsychotics, Benzodiazepines and Counseling/psycho-education. Telepsychiatry is a viable method of delivering service even during the pandemic.