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An inverted papilloma of the urinary tract is a rare benign lesion. A 35-year-old male presented gross hematuria. Cystoscopy showed one, papillary tumor at the bladder trigone. Transurethral resection was done, and histological examination has concluded in the diagnosis of inverted papilloma. Following resection, the patient was asymptomatic with no hematuria and no recurrence after a five-year cystoscopy control. We report a case of bladder Inverted papilloma and we aim to remind the clinical, histological, and therapeutic features of this rare tumor.

As addiction counselors suffer from Burnout (BO) and Compassion Fatigue (CF), turnover rates increase and subsequently, there are fewer addiction counselors available to provide care for those experiencing addiction. A qualitative transcendental phenomenological study was conducted to interview addiction counselors believed to be resilient to BO and CF. All nine participants held the Master Addiction Counselor (MAC) certification awarded by the National Certification Commission for Addiction Professionals (NCC AP) and worked in addiction counseling for five years minimum. Previous studies show only 58% of addiction counselors remain in the field for five or more years and 29% maintain their current job for 5 or more years (therefore resiliency in this sample was inferred). Identified themes relating to resiliency factors were gleaned and implications were explored.

Background: Congenital Vascular malformation relatively rare and extremely varied clinical presentations. The purpose of our study was to present our initial experience of embolization in a series of 26 patients with congenital vascular malformation to assess retrospectively the results and the complications of ethanol and coils embolization treatment of these patients. Methods: Retrospective trial, the study group consisted of 26 patients with congenital vascular malformations. Transcatheter arterial embolization by ethanol or coils were performed, Therapeutic outcomes were established by evaluating the clinical outcome of symptoms and signs, as well as the degree of devascularization at follow-up angiography. Results: Between November 2014 and March 2018, 26 consecutive patients (3 male, 23 female) at Alshifa Hospital - Cardiac Catheterization Center with congenital vascular malformations in the body and extremities underwent staged ethanol or coils embolization. The mean age of the patients was 25 years (age range, 6– 59 years). Ethanol embolization was administrated in 16 patients, coil embolization in 9 patients and graft stent in one patient. The side effect such as pain, pulsation, and bruit in most of the patients were obtained. The reduction of redness, swelling, and warmth was achieved in all of the patients, According to the angiographic findings, congenital vascular malformation were devascularized 100% in 12 patients, 50% to 99% in 11 patients, less than 50% in 3 patients. The most common complications were reversible skin necrosis. Conclusion: Transcatheter embolization by ethanol or coils has proved efficacious and safe in the treatment of congenital vascular malformation of the body and extremities but with acceptable risk of complications

This research was conducted over period of 3 months with the aim of studying Age related changes of selected bones of forelimb (Scapula, Humerus, Radius and Ulna) in Local Mongrelian Dog (Canis lupus familiaris). The study entails biometrical and gross observations on the bones. The sample bones were acquired from the experimental animals of comparative anatomy in the department. The bones were categorized into various age groups for the research. The length, width, diameter and circumference of the samples (scapula, humerus, radius and ulna bones) were determined for all the groups. The shape, size, color, location, position and relation of each segment of the samples at various stages of development were determined. The differences across the age groups of different samples were observed and recorded. Based on the research result, it was concluded that, the biometric and morphometry data was found to be increasing with advancement of age. A baseline data was established with the view to enhance learning.

Evaluation of semen characteristics is an important and prior for semen preservation. The aim of this study was to collection and evaluation of indigenous buck semen in the coastal region of Bangladesh. The semen was collected from bucks through artificial vagina method. The colour, odour, volume, viscosity, mass activity, consistency, concentration and individual sperm motility were analysed and recorded after collection from pre-selected four bucks. The colour and odour of all buck (B) semen were creamy white to milky white and fishy smell, respectively. In this study, we found that the average volume of B-1, B-2, B-3 and B-4 were 0.74, 0.98, 0.42 and 0.60 ml, respectively. The average grading of viscosity of B-1, B-2, B-3 and B-4 were 3.2, 3.8, 2.6 and 3.0, respectively. The average grading of mass activity of B-1, B-2, B-3 and B-4 were 3.6, 3.2, 2.4 and 3.4, respectively. The consistency of B-1, B-2, B-3 and B-4 were 4.2, 4.8, 2.8 and 4.0, respectively. The concentration of B-1, B-2, B-3 and B-4 were 1.58, 1.94, 0.62 and 1.54 ×109 per ml of semen volume. The average percentage of individual sperm motility of B-1, B-2, B-3 and B-4 were 81, 71, 66 and 80%, respectively. Viscosity, mass activity, consistency, concentration and individual sperm motility were significantly (p < 0.05) correlate with each other. It may be concluded that the data about semen of the bucks are in acceptable level for preservation. Further study will be designed for the evaluation of viability and motility of sperm before and after freezing as liquid semen.

Maternal mortality accounts for most deaths in agrarian communities of Nigeria due to poor access to midwives services and inadequate Skilled Birth Attendants (SBAs). The Midwives Service Scheme (MSS) was established to engage more SBAs and advocate better utilization of pre and post-natal care services. Studies have focused on maternal mortality reduction, however, information on underlying factors that predispose MSS target beneficiaries to its utilization is scarce. Therefore, utilization of MSS among women farmers in southwestern Nigeria was investigated. A four-stage sampling procedure was used. Three states from southwestern states (Oyo, Ogun and Ekiti) were randomly selected. Thereafter, ten Local Government Areas (LGAs) from eighteen LGAs that adopted MSS programme in the selected states were sampled. Also, 30% of the MSS facilities in the sampled LGAs were selected, resulting in 13 MSS facilities. Proportionate sampling technique was used to select 20% of registered women farmers in the selected 13 MSS facilities to give 207 respondents. Interview schedule was used to collect data on respondents’ socioeconomic characteristics, Maternal Health Information Sources (MHIS), Maternal Health Information Seeking Behavior (MHISB) and utilization of MSS. Data were analyzed using descriptive and inferential statistics. About (55.6%) of the respondents had formal education. MHISB and effectiveness of MSS was rated low by 53.2% and 55.6% of the respondents, respectively. MSS was moderately utilized by 64.7% of the respondents. The MSS utilization was 49.24 ± 11.39 (Oyo), 45.08 ± 9.28 (Ogun) and 44.00 ± 10.71 (Ekiti). Respondents’ education (χ2 = 12.85), family size (r = 0.02), monthly income (r = 0.48) related positively and significantly (r = 0.27) to MSS utilization.

Considering the performance of supply chains in the three dimensions of sustainability; Economic, Social, and Environmental, ESG scores can function as a measurement scale [1]. Environmental, social and corporate governance (ESG) is an extension and enrichment of the concept of Socially Responsible Investment (SRI) and is an important measure of corporate sustainable development [2,3].

Introduction: Sepsis is an important cause of morbidity and mortality among neonates. Neonatal sepsis can alter the glucose level and both hypoglycemia and hyperglycemia may occur. A high or low blood glucose level may have a significant effect on the outcomes in patients of neonatal sepsis. Aims: The aim of the study to see the glycaemic status and its effect on outcome of neonatal sepsis. Material and Methods: This hospital based prospective observational cross-sectional study was conducted in Neonatal Intensive Care Unit in Universal College of Medical Sciences, a tertiary care hospital over a period of 4 months, from May 2019 to August 2019. A total of 220 Neonates suspected sepsis under the age of 28 days admitted in NICU, were studied and included in our study. Clinically suspected neonatal sepsis cases were enrolled in the study. Venous blood was collected before giving any intravenous fluid, dextrose or antibiotics and blood sugar, complete blood counts, CRP levels and blood culture were send to laboratory within half hour of collection. All patients included in this study were treated accordingly and followed up strictly. Blood glucose level and mortality of neonates having hypoglycemia, hyperglycemia were analyzed among CRP and culture positive patients. Quantitative data were expressed as mean and standard deviation. Qualitative data were expressed as frequency and percentage and comparison carried by Chi-square (χ2) test. Results: A total of 220 patients clinically diagnosed as neonatal sepsis were studied. 118 (53.6%) patients were found CRP positive and 56 (25.5%) patients were blood culture positive. Glycaemic status was analyzed among CRP and culture positive patients. Majority (55.9%) patients were found normoglycemic, 35.5% were found hypoglycemic and 8.6% were found hyperglycaemic in this study. 182 (82.73%) patients were cured and 38 (17.27%) died. Mortality was high in hypoglycaemic patients (34.4%) compared with normoglycaemic patients (9.82%), but the difference was not statistically significant (p > 0.05) between two groups, the mortality was high in hyperglycaemic patients (58.33%) compared with normoglycaemic patients (9.82%) and the difference was statistically significant (p < 0.05) between two groups. Conclusion: Alteration of glycaemic status occurred in septic newborn. Mortality is higher among the septic newborn with hyperglycemia. The present study found that majority of neonate with sepsis had high mortality rate when blood glucose level were either more than 145 mg/dl or less than 45 mg/dl. This signifies the importance of meticulous blood glucose estimation in cases of neonatal sepsis to improve mortality outcome.

Introduction: Current pediatric residents spend less time in the neonatal intensive care unit (NICU) and as a result, resident exposure to neonatal pathophysiology has decreased. Engaging learners efficiently while balancing clinical demands is challenging. Practices to enhance adult education include integration of problem centered learning into the demands of daily life in an environment in which learners feel safe asking questions and expressing themselves. Methods: With this principal in mind, we developed a curriculum to enhance resident and medical student education during busy NICU rotations. The curriculum was case-based, available on-line and facilitated by neonatology faculty and fellows. A template designed to be concise and interactive was used to create and present the cases. After the case vignette, the template prompted medical students and residents to generate a differential diagnosis, order a diagnostic workup and narrow the diagnosis. Discussion of the diagnoses occurred at the conclusion of the cases; however, the template discouraged didactic lectures. Results: In two years, cases were viewed 2,362 times. Facilitators and learners rated the quality and utility of the cases favorably overall. Cases took approximately 20 minutes to complete. Approximately 57% of survey respondents reviewed 1-2 cases per week and 9.6% reviewed 3-5 cases per week. Discussion: A template with a concise and consistent format to construct and present cases allows for the creation of a curriculum that can be incorporated into a clinically demanding service and may enhance clinical teaching and learner engagement.

Sclerotinia sclerotiorum is a necrotrophic plant pathogen causing more than 60 different disease symptoms in approximately 400 plants globally. Hence, due to this distinctive characteristic, S. sclerotiorum has been the subject of various research to comprehend its pathogenicity mechanism, including virulent genes, proteins, and metabolites. Likewise, the genomic annotation of S. sclerotiorum uncovered its remarkable potential for producing secondary metabolites, of which genome mining has additionally prompted the disclosure of these uncharacterized metabolic pathways, which might aid the pathogenicity process. To comprehend the secondary metabolites secreted by S. sclerotiorum that might be involved in its pathogenicity, a secondary metabolite-level investigation of this plant pathogen was performed. Profiling and characterizing these secondary metabolites produced during in vitro germination would increase the current knowledge of this pathogen. In this study, S. sclerotiorum secondary metabolites profile examination was conducted, utilizing the Ultra-High Resolution Qq-Time-Of-Flight mass spectrometer (UHR-QqTOF). Proficient data analysis and verification with the genomic pathways of S. sclerotiorum gave an unequivocal metabolome profile of this pathogen. Two hundred and thirty secondary metabolites were identified in all three biological replicates, and their bodily functions were identified.