Introduction: The dilation of the bile ducts which the obstacle could not be visualized by conventional imaging, constitutes a daily challenge in our medical practice. This work aims to evaluate the frequency and the role of biliopancreatic echo-endoscopy in the etiological diagnosis of bile duct dilatation. Material and methods: This is a descriptive and monocentric retrospective study conducted within the department of 'Digestive Functional Explorations and Hepato-gastro-enterology' at the Ibn Sina Hospital in Rabat, from September 2015 to April 2023. It includes 115 patients admitted for dilation of the common bile duct with no visible obstacle to conventional imaging and who underwent a bilio-pancreatic echo-endoscopy. Results: Our study included 81 patients, whose mean age was 61.2 years with a clear female predominance. Echo-endoscopy confirmed the presence of bile duct dilation in 67% of cases. It established an etiological diagnosis in 82% of cases. Lithiasis of the common bile duct was found in 42,9% of cases, followed by cystic dilation in 12,9% of cases and chronic pancreatitis in 5.2% of cases. A pancreatic tumor has been revealed in 3,8% of cases as well as an ampulloma in 3,8% of cases. Conclusion: Our study, despite its limitations, highlight the role and performance of biliopancreatic echoendoscopy in the etiological diagnosis of bile duct dilatation without any visible obstacle to conventional imaging.

Background and Objectives: The rates of Cardiac implantable electronic device (CIED) infections are increasing worldwide due to the increased use of these devices. (CIED) infection is a serious complication that is associated with increased mortality, morbidity and healthcare costs. There is a need to investigate data on the microbiology of CIED infections since it is poorly documented in Saudi Arabia. We aimed to determine microbiological findings of CIED infections in our region. Methods and Results: The study was carried out in cardiology departments at different centers in Saudi Arabia. Our population consisted of all patients with device-related infections over a period of eleven years from January 2009 to December 2020. It was resulting in 137 patients with device infection. Blood cultures and device material swabs were obtained. Staphylococcus aureus was the most common isolated pathogen (37.2%). particularly, coagulase-negative Staphylococcus aureus in 15.3% of cases, Methicillin-susceptible Staphylococcus aureus (MSSA) in 13.9% of cases and Methicillin-resistant Staphylococcus aureus (MRSA) in 8% of cases. Brucella accounted for 9.5% of cases. Negative cultures of CIED infections seemed to be a critical issue over the studied years. Conclusion: Staphylococcus aureus was the most frequently isolated pathogen and Brucella is a considerable pathogen for CIED infections in our country.

In Sour Sweet, Timothy Mo tells a story about a Chinese family’s struggle in the UK. After experiencing a serious of cultural conflicts, among the three family members Chen, Lily and Mui, only Lily achieves a delicate balance. After defining the process of establishing oneself in a new environment as a kind of translation, this paper applies André Lefevere’s thoughts to study the three characters’ different responses to the cultural conflicts, analyzes how different strategies adopted affect each character’s translation, and explains why does or doesn’t he/she translates himself/herself successfully.

This study aims to investigate the problems and challenges which is usually experienced by English learner's students in the Saudi universities when trying to speak English. It also checks at the problems that students face when learning English language in Saudi universities and try to find remedies to this problem. The research uses a questionnaire, interviews, and descriptive methods in the collection of data about fluency in English language in universities in KSU as an example. The data was then statistically analyzed using the SPSS program. The results showed that there are various problems which hinder fluency of English learning in the universities and among them include: under-qualified teachers, unsuitable teaching materials and the methods used in teaching are also poor. The other problem is the psychological factor which makes student lack motivation while learning English. The study also contains ways in which these problems can be handled to bring efficiency in learning and teaching English in Saudi universities.

Introduction: Oligohydramnios is a pregnancy disorder characterized by a shortage of amniotic fluid volume. It is a rather common obstetric complication that has severe effects on the health of both the mother and the fetus. Early identification is essential for prompt diagnosis and therapy because the clinical appearance of oligohydramnios can vary greatly. This study aimed to investigate the various modes of presentation of oligohydramnios in patients admitted to Bangabandhu Sheikh Mujib Medical University (BSMMU), a tertiary care hospital in Bangladesh. Methods: This prospective observational study was carried out on the admitted patients at the Department of Gynaecology and Obstetrics in Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from February to July 2008 (6 months). A total of fifty women (N=50) having Oligohydramnios in pregnancy were included in the study. Completed data forms were reviewed, edited, and processed for computer data entry. The data analysis was performed using Statistical Package for Social Sciences (SPSS) Version 25.0.The ethical clearance of this study was obtained from the Institutional Review Board (IRB) of BSMMU, Dhaka, Bangladesh. Results: The mean age of the mothers was 25.8 years and two-fifths of the mothers (20, 40.0%) belonged to 21-25 years old. Twenty-three mothers (23, 46.0%) were nulliparous. Of fifty mothers (N=50), eighteen (18, 36.0%) had borderline oligohydramnios and thirty-two (32, 64.0%) had severe oligohydramnios. Normal CTG tracing was found in eighteen patients (18, 36.0%) and abnormal CTG was found in thirty-two patients (32, 64%) (p < 0.01) which was statistically significant. Among the alive babies after initial resuscitation, twenty-three babies (23, 50.0%) were required to get admitted. Twelve admitted babies (12,52.2%) stayed in the neonatal ward for <7 days and among them one baby (1,8.3%) died, nine babies (9,39.1%) were treated for 7—21 days, among them two babies (2,22.2%) could not survive and two babies were treated for more than 21 days but could not survive. Conclusion: According to the findings, severe oligohydramnios was linked to a higher risk of cesarean delivery, higher APGAR ratings, and probable issues that would necessitate neonatal admission and care.

Ray Bradbury's Fahrenheit 451 is a text of sempiternal pertinence for myriad reasons. Some of them are beyond our ken while some are ineffable. Bradbury’s prescient and trenchant critique of the culture industry has often been neglected or overlooked for no fault of his. The consensus of the critics’ opinion for instance, attests to this fact. Although many critics and literary scholars have classified this novel under the rubric of dystopian fiction, it’s far from the truth. Brecht’s poem about burning books/censorship was premonitory in many ways. However, the landscape isn’t Germany but America, a land that has always been identified as a beacon of hope for writers and artists from across the globe. This short review in spite of its shortcomings will focus on the text and its perennial relevance in a world that has always shown a predilection for conspicuous consumption and dilettantism.

Background: Konzo is related to a habit of long-term consumption of cassava; it is a chronic disease with quite different symptoms from acute cassava poisoning. The ameliorative effect of soya beans and brown beans in degenerative changes expressed in cortical NeuN immunoreactivity in a konzo disease rat model was investigated in the present study. Materials and Methods: 30 male wistar rats weighing 200-250g were assigned to Group 1 (Control, n=5) and was fed on animal pellet, whereas Group 2 (Protein, n=5) was administered with protein food (Soya beans+Brown bean). Bitter cassava flour was provided to Group 3 (cassava-induced Konzo, n=15). Protein (Soya beans+Brown bean) and bitter cassava flour were administered to Group 4 (protein treatment group, n=5). The Cerebrum (primary motor cortex) region was harvested through transcardiac perfusion for histological and immunohistochemical staining. Image J was used to quantify the neurons in the motor cortex. We examined general structures in the primary motor cortex with hematoxylin and eosin (H&E) stain. Result and Discussion: H&E demonstration showed distinct pyramidal neurons with large round nucleus, and prominent nucleoli in the Control group. Interspersed between the pyramidal neurons were numerous glia cells. Protein (Soya beans+Brown bean) group, Cassava group, and Cassava + Protein group also showed intact histology of the cortex compared to control usig H&E stain. NeuN stains analyzed immunoreactive neurons. The rats fed on cassava showed significant decrease in the NeuN immunoreactive neurons at ***[p<.001] compared to the Control and Protein administered group, whereas Cassava + Protein groups showed decrease NeuN immunoreactive neurons at**p<0.1 compared to Protein group(Soya beans+Brown bean). Conclusions: This study has provided an empirical data on the ameliorative effect of soya beans and brown beans supplement on Cassava-induced konzo disease animal model. This data will be very useful to Anatomists, konzo researchers and neuroscientist.

Introduction: Composite resins can be effectively recycled to progress the patient's esthetics concluded minimally invasive, low cost and high clinical presentation managements. The layering techniques of composite resins in different thicknesses, with varying grades of opacity and translucency, permit to create esthetic restorations with dental structures physical appearance. Aim: The intention of the training was to appraise the characteristics, values and approaches of stratification of resins composite materials and to demonstrate these approaches with clinical cases. Materials and method: An electronic search of scientific articles referring to the stratification of composite materials was done using a single medical database. The attention on the choice of keywords as well as the presence and elimination criteria were the directorial elements of the research. All articles were included after the title, the abstract and finally, the full text was checked. Only relevant research has been reviewed. Based on the results, several methods of stratifications have been used in clinical practice. Results and discussion: The concept of natural stratification, anatomical stratification, the stratification of the anterior teeth using a dentine hue and a predefined thickness of enamel, or a single layer of material and the correct placement of pigments and opacities, lead to the achievement of esthetic and predictable direct restorations of nanocomposite resins. Conclusions: Within the limit of this study, it is concluded that, to achieve aesthetic excellence, dentists should understand and apply artistic and scientific principles when layering materials, respecting the optical properties of natural dental structures.

Background: Konzo disease is a neurological condition that affects the upper and lower motor neurons. This disease is prevalent in females and youngsters. The effects of soya beans and brown beans on neurobehavioural deficit in Cassava-induced konzo disease rat model were investigated in the present study. Materials and Methods: 30 male wistar rats weighing 200-250g were assigned to Group 1 (Control, n=5). They were fed on animal pellet, whereas Group 2 (Soya and Brown Beans, n=5) was provided Soya and Brown Beans. Bitter cassava flour was provided to Group 3 (cassava induced Konzo, n=15). Protein (Soya and Brown Beans) and bitter cassava flour were supplied to Group 4 (protein treatment group, n=5). Neurobehavioural paradigms (Forelimb grip strength and gait test) were carried out to assess the effect of cyanogenic bitter cassava on motor coordination. Result and Discussion: Forelimb grip strength test showed significant decrease in the grip strength in Cassava group compared to Control and Protein(Soya and Brown Beans) group (p<0.01). It was observed that there was significant increase in grip strength test in the Cassava+ Protein (Soya beans and Brown Beans) when compared to Cassava group (p<0.05). Gait test showed significant decrease in the stance, stride and sway length of Cassava group when compared to the Control and Protein (Soya and Brown Beans) group (p<0.01). However, Cassava+ Protein group had a significant increase in stance, stride and sway length when compare to Cassava group (p<0.05). Conclusions: This study has provided a reference data on the ameliorative effects of Soya beans and Brown Beans on the neurobehavior of Cassava induced Konzo disease rat model. The ameliorative effects may be as a result of the presence of flavonoids and tannins in the brown beans and soya beans. This study will be useful to the Anatomists and Neuroscientist.

Manufar wannan bincike shi ne shiga duniyar tarihi domin taliyon gudummawar Turawa wajen samarwa da bunƙasa ƙa’idojin rubutun Hausa. Kadadar binciken ta taƙaita tsakanin 1840 zuwa 1993. An yi amfani da dabarar salon binciken laburare (library research) domin tattara bayanai inda aka dogara kan kundatattun bayanan tarihi. Binciken ya gano cewa, Turawa ne suka fara samar da tubalan ginin rubutun Hausa, sannan sun taka rawar gani sosai wajen gina ƙa’idojin rubutun Hausa kafin a samu Hausawan da suka ci gaba da jan ragamar wannan fagen ilimi. Daga ƙarshe takardar ta ba da shawarwarin da suka haɗa da samun haɗin kan masana da manazarta tare da aiki tuƙuru bisa sadaukarwa domin samun cigaba da bunƙasar ƙa’idojin rubutun Hausa tare da harshen baki ɗaya. Dole ne kuma a samu ingantattun hanyoyin watsa sababbin cigaba da amintattun sauye-sauye da ake samarwa.

The purpose of this research is to determine the internal and external factors that affect economic growth, then determine strategies to increase economic growth in 6 (six) provinces in Indonesia. The research method uses descriptive analysis with SWOT analysis tools. The results of the study are appropriate strategies to accelerate the economic growth of the Province in Java Island, including: improving infrastructure, developing special economic zones, promoting tourism and cultural heritage, encouraging innovation and technology, regional development planning and sustainable development practices.

The Policy provides a consistent framework for operational guidelines and standardized processes for decision making. Policy Development Framework provides protocols and clarifies roles and responsibilities in the policy development process. This article aims to document and discuss the process of development cross training policy formulation, including its practice and outcomes. In this policy, we developed the cross training framework including definitions, purpose and procedures that reflect the scope of policy analysis. This comprehensive conceptual framework may serve as a “road map” for researchers and healthcare policymakers who are interested in the development, monitoring, implementation, and analysis of nursing cross training policies.

Malaria remains a significant public health concern, particularly among pregnant women in sub-Saharan Africa. Long Lasting Insecticidal Nets (LLINs) have been recognized as an effective preventive measure against malaria transmission. However, the utilization of LLINs among pregnant women remains suboptimal. This study aimed to assess the level of daily LLIN utilization and identify its predictors among pregnant women receiving antenatal care in a tertiary healthcare centre in Southern Nigeria. A cross-sectional study was conducted among antenatal recipients at the University of Uyo Teaching Hospital in Uyo, AkwaIbom State. A total of 323 respondents were recruited for the study. Data were collected using a pre-tested semi-structured questionnaire. Multivariable logistic regression analyses were performed to identify predictors of daily LLIN usage. One hundred and twenty seven (39.3%) of the respondents had ever slept inside a LLIN during the index pregnancy, while 22.6% reported daily usage. LLIN ownership was reported by 47.7% of the respondents, highlighting a discrepancy between ownership and consistent use. Predictors of daily LLIN usage included LLIN ownership (aOR 3.83, 95% CI 1.95-7.48), absence of discomfort during LLIN use (aOR 9.33,95%CI 4.32-20.17), non-use of other malaria preventive measures (aOR 3.7,95% CI 11.51-8.93) and presence of mosquitoes in home dwelling (aOR 3.56 95%CI 1.35-9.37). Health education campaigns should emphasize the benefits of daily LLIN usage during pregnancy. Policy interventions are warranted to increase LLIN distribution and availability to pregnant women through antenatal care clinics.

Introduction: The estimation of fetal weight during pregnancy has a significant impact on the survival of newborns and some immediate and late sequelae of the life of newborns. Estimation of fetal weight also plays a paramount role in determining time, mode, and place of delivery. There are many methods to estimate fetal weight like the palpation method, fundal height measurement, and radio frequency volume reduction. Johnson's method is one of the clinical methods that require no expense and is easier to estimate the precise birth weight and fetal weight. This study aimed to analyze the accuracy of the Johnsons formula for estimating fetal weight compared to actual birth weight. Methods: This cross-sectional prospective study took place in the Gynecology and Obstetrics Department of Rangpur Medical College Hospital, Rangpur, between May 2015 to October 2015, six (06) months after approval. The sample size was 600 as per inclusion criteria. Data were collected through face-to-face interviews with the women by using a pre- design questionnaire after proper counseling and informed written consent. The purposive sampling method was used in the study. Data processing was consisting of registration schedule, editing, computerization, preparation of dummy table, analyzing & matching of data. Statistical analysis was carried out by using the Statistical Package for Social Sciences version 16.0 for Windows. The mean values were calculated for continuous variables. The quantitative observations were indicated by frequencies and percentages. Paired t-test was used for continuous variables. Pearson's correlation coefficients were used to test the relationship between the groups. P values <0.05 was considered statistically significant. Result: The mean age was found 24.5±5.1 years with a range from 18 to 38 years. The mean symphysio fundal height was found 32.4±2.0 cm with a range from 28 to 36 cm. The mean estimated fetal weight was found 3205.2±287.9 grams with a range from 2635 to 3875 grams. The mean actual birth weight after delivery was found 3019.0±359.0 grams with a range from 2200 to 3800 grams. The difference was statistically significant (p<0.05) between the two groups. A positive significant correlation (r=0.929; p=0.001) was found between actual birth weight and estimated fetal weight by Johnson's formula. A positive significant correlation (r=0.517; p=0.001) was found between actual birth weight and symphysio fundal height. A positive significant correlation (r=0.129; p=0.002) was also found between the actual birth weight neonate and the BMI of the mother. Conclusion: Antenatal and intranatal fetal weight can be estimated with reasonable accuracy, clinically using Johnson's formula. Ultrasound is not available in remote areas where Johnson's formula is easy and simple to calculate and can be included in the training program of medical and paramedical staff and birth attendants.

In today’s healthcare system, informatics has become an essential part of the infrastructure to improve access to health information, make patient care safer, decrease health care costs, and improve outcomes. The evaluation of these services is an important component of these programs and health professionals should have the requisite knowledge, confidence, and skills to evaluate the impact of the services they provide. However, Nursing staff are seldom adequately prepared by their training or work experience to do this well. In this article the researchers provide a suitable framework and guidance to enable nursing staff to appropriately undertake useful program evaluation. We introduced and discussed Program Evaluation and provided guidelines for its implementation. The framework presented distinguishes program evaluation from research and encourages nursing staff to apply an evaluative judgment, in order that value the merit, worth, and significance of programs can be made. Examples from our evaluation practice are drawn on to illustrate how program evaluation can be used across the Nursing care scope.